Cut the Red Tape Because Patient Care Can’t Wait
It’s time to fix broken prior authorizations.
“Imagine forcing a patient with a severe illness to wait days or weeks for authorization from an insurance company to start treatment. Now imagine a doctor having to employ multiple back-office personnel just to manage that insurer-imposed burden. Patients are left waiting for approval of necessary care and physicians are drowning in red tape.”
Dr. George Koulianos, a physician in Mobile
When insurance companies get between patients and their physicians, three things happen:
Patient care gets delayed.
This process is meant to control costs but ends up causing long waits and stress for patients needing treatment. Doctors spend too much time filling out forms and waiting for approvals instead of caring for patients.
Doctors get buried under red tape.
This leads to worsened health conditions for some patients and damages the trust between them and their physicians. In short, prior authorization can make it hard for patients to get timely and effective treatment.
Health care gets more expensive.
It requires additional administrative work and delays in treatment, leading to increased healthcare expenses for both employers and patients.
That’s why Alabama physicians and patient advocates are working together to fix prior authorizations. Prior authorizations require doctors to get insurers’ approval before patients can get the medical tests, medicines and other treatments their doctors say they need.
“In order to get the care the patient needs you have to jump through these hoops. It’s very frustrating for physicians as well as the patient.”
– Dr. Gregory Ayers, Birmingham physician
“With prior authorizations, we definitely see delay in patient care. I see delays in patients getting chemo, I see delays in patients getting tests they need to diagnose problems that can be very urgent.”
– Dr. Tonya Bradley, a physician in Auburn
“We try our best to spend that quality time with each patient but then we’re also having to do a lot of paperwork behind it and talking with insurance companies and figuring out – ‘Well, you just approved this medication 6 or 12 months ago. Why are we going through this red tape again?’”
– Dr. Nina Ford-Johnson, a physician in Mobile
“If you can spend the time to explain to your patient why you’re recommending a test or why you’re recommending a treatment, and be able to answer all the questions they have, and assuage any concerns or apprehensions they have, then that directly affects how well they do. It directly affects whether they get better or not. And so we abhor anything that interferes or cuts into that time that we have to do that with our patients.”
– Dr. Hernando Carter, a physician in Birmingham
“If we can speed up the care of patients and speed up prior authorizations, it allows patients to get quick access to health care, take care of their illness, go about the business of healing and get back into being productive community members.”
– Dr. William Admire, a physician in Mobile
“Absolutely [patients] get frustrated because they need a medication and they can’t get it. They’ve been on it for a year. It’s worked well. Then all of a sudden, we’re told, ‘No, you have to send in another prior authorization.’ And it doesn’t make sense that they still have that chronic condition and we have to send it in again. It takes a lot of time. The patient might run out of their medication. That’s just not safe.”
– Dr. Jane Weida, a physician in Tuscaloosa
“We went to medical school to take care of patients and to help people but we spend a good bit of our day doing paperwork and going back and forth with insurance companies and things like that. It can be really taxing for physicians.”
– Dr. Brittney Anderson, a physician in Demopolis