Patients and Physicians Speak Out

I waited 4 months for a prescription of budesonide for treatment of microscopic lymphocytic colitis (uncontrollable diarrhea). Twice.

I am an ED RN. I frequently see patients who have seen their family doctor and have a CT ordered. The insurance company hasn't authorized them yet so they come to the ED to get a CT. Sometimes they come on their own, sometimes the doctor sends them, so they can get the test in a timely manner.

I worked for the largest PBM around. I have many heartbreaking stories.

I work in a 24-bed Intermediate Care Facility for Individuals with Intellectual Disabilities. We haven't been able to provide at least 6 different medications to our clients due to the need for prior authorization. There are 9 medications that we got from our pharmacy, but may have to pay for as a facility pending prior authorization. These are not expensive medications for the most part and are essential for our clients' quality of life!

I work in healthcare. Providers are jumping through too many hoops, at great financial cost, to be able to provide clinically appropriate and medically necessary treatment for their patients. We get a prior authorization, only to have our claims be denied for "no auth." Healthcare decisions should be left to the clinician, not the insurance carrier. The prior authorization process is broken and needs to be overhauled.

I am a Geriatric Social Worker in a senior residence. Prior authorization delays treatment, prolongs pain and cuts vital treatment short or off. These delays cost us all when Medicare and Medicaid patients use the ER post hospital or rehab discharge or while awaiting insurance approval for a procedure.