Cross-Post: Insurance Companies Use Stalling Tactics to Save Themselves Money

Cross-Post: Insurance Companies Use Stalling Tactics to Save Themselves Money

Dark operating room, surgeons make a complex ancological operation. Female team of surgeons. The concept of medecine.

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in The American Spectator on Jan. 3. In the op-ed, neurosurgeon Richard Menger, MD, MPA, FAANS and nurses Jessica Murfee, RN, BSN and Erin Roberts, RN, BSN, discuss health care provider burnout from the cumbersome prior authorization process required by insurance companies to perform surgery agreed upon by patient and surgeon.

The time-consuming prior authorization process disregards the patient-physician relationship. It also causes burnout for health care workers, and “Most of the time, it’s an administrative clarification issue, but calling into the insurance abyss is like dialing into a time warp.”

See 2021 AMA prior authorization physician survey

A survey from the American Medical Association noted that, on average, offices spend 13 hours per week on prior authorizations. The article states, “If a higher-level evaluation is needed, either myself or my physician assistant or nurse practitioner will have to get on the line and debate the merits of a neurosurgery with some other type of health representative who is acting on behalf of the insurance company.”

The piece concludes with the authors asking Congress to take action and pass legislation to streamline prior authorization in Medicare Advantage. The Improving Seniors Timely Access to Care Act would require enhanced transparency and streamline authorization in the Medicare Advantage program.

Click here to read the full article.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #FixPriorAuth.

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Disclaimer

This blog is a product of The American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS). The material on this site is for informational purposes only, and is not a substitute for medical advice and is not intended to replace consultation with a qualified neurosurgical professional.

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