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.
Sometimes [prior authorization] INCREASES the cost of care, which it is intended to combat. For example, certain higher level imaging studies are needed, no matter what, to evaluate for a condition. Carriers have blanket requirements that lower-level imaging be performed first, and in certain cases, this lower-level imaging will not help at all- it will not change the fact that the higher-level imaging is necessary. So, insurers are REQUIRING that we order two studies instead of one. The alternative is to send a patient through the ER, which is clearly not cost-effective for a condition [that] can be managed at the outpatient level. This is unnecessary, wasteful, and contributes to increased costs for all. All of this AND calling to do a "peer-to-peer" discussion has no impact: the "peer" can't waive the lower-level imaging requirement even when they medically agree, and it takes up at least 30 minutes of time, which would easily be 1-2 more patient visits.