Patients and Physicians Speak Out
Prior authorization burdens negatively impact patients and health care professionals around the country every day. Explore their stories and share your own experiences to make your voice heard on the need to #FixPriorAuth.
Featured Stories
Yes, just last year I needed knee surgery. The insurance made me go through 2 weeks of resting it then 3 weeks of physical therapy plus a fluid removal attempt. All this before I could even get an MRI that my ortho doc with 40 yrs experience knew I needed in the first place. After the MRI I had to wait 2 more weeks for approval. From start to finish I was laid up 4 months and even lost my job because I ran out of FMLA. Now I have a wrist injury and I am not going for treatment because I really like my new job and I am afraid to go through it all again.
I went almost two weeks without long-acting insulin and two days without even short-acting insulin waiting for prior authorizations. This landed me in the ER 3 times and sent me into a pancreatitis flare. And wasted about 3 hours of my doctor’s time to get insulin. This was not new either; I have been diabetic since I was a kid, so about 25 years. They also made me switch what kind I use, and that caused my sugar to be out of control for weeks, even after I finally got the insulin, while I determined my correct bolus dose of the new insulin.
Share Your Story
Have you ever gone to the pharmacy to fill a prescription only to be told that your insurance company requires approval before they'll cover your treatment?
Have you ever waited days, weeks or months for a test or medical procedure to be scheduled because you needed authorization from an insurer?
Are you a physician frustrated with the administrative headaches and their impact on your patients?
Have prior authorization delays caused you to take more sick days, be less productive at work or miss out on day-to-day life?
Share how prior authorization has impacted you, your loved ones or your patients to draw attention to the need for decision-makers to address this issue. Your voice can make an impact.
All Stories
Use the buttons below to explore how prior authorization impacts both health care professionals and patients throughout the country.
If we try to do the work ourselves, our limited staff is taken away from patient care for 30-45 minutes with each incident. Prior authorization directly devalues the doctor-patient relationship. It creates a hostile work environment within my office staff as the process is demeaning and abusive. I want to retire ASAP.
Every time I get a prior auth I want to scream! These take my staff away from actually helping me with practicing medicine. Then we spend countless hours on doing these and half the time we get them covered the patient's co-pay is too high for them to afford. I always start with the cheapest medications first and only go to new ones when these have failed. This is just a stalling tactic for insurance to keep from paying for a more expensive medication.
Prior authorization significantly interferes with patient care. Insurance companies are practicing medicine without a license and without holding any responsibility or liability… it is amoral to have CEOs and other officials make millions of dollars in compensation at the expense of people’s illnesses and misery. It is indefensible. Period.
Prior authorizations take up significant staff resources. We have a full-time nurse and per diem nurse coming in every day spend all day doing prior authorizations instead of helping care for patients or addressing patient concerns. Limiting physician choices in management prevents doctors from providing individualized care to patients. In the majority of cases, prior authorizations delay treatment, which in psychiatry can have dangerous consequences.
Never have I encountered a reasonable situation where filling out a prior authorization was important either for the patient or myself. It can delay important medications after a discharge if a PA need is not known prior to discharge and delays therapy. It is a process that could be applied after the fact if there was cost saving concerns rather than delay potential therapy. Absolutely ridiculous, inefficient, and benefits neither the patient or physician and has the potential to do more harm than intended benefit of potential cost-savings for the insurance industry!
I save applying for prior authorizations until the end of the day to keep me from swearing out loud when there are patients around. My blood pressure goes up. In the last week I have had rejections (for rheumatology drugs) by a "bought and paid for" ER doc and radiologist.... I have to then write an appeal letter and "remind" the reviewer that these persons have rendered a verdict outside of their areas of expertise. I almost always get a rejection overturned, but the waste of time and energy is overwhelming to me—let alone the patient when that person needs care ASAP. Every year the insurers get deals on different drugs and then the whole tier action gets redistributed and folks who have been on certain meds for YEARS and in good control without side effects are thrown to the wolves and FORCED to get on a drug that may cause significant side effects. (My blood pressure is rising as I write this... I'd better stop now!!)