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.
Nothing I love more than my morning cup of coffee to go alongside my daily peer-to-peers before clinic is even open yet. Extra exciting when the “peer” opens the conversation with “I am a RETIRED PSYCH (or other unrelated field) DOC with BCBS calling to discuss why your (insert GASTROENTEROLOGY specific procedure/testing/medication) was denied.”
And then they literally ask me questions that they could have answered themselves by reading the notes I provided them 2 months ago, and again with the letter of medical necessity I wrote them, and again with the appeal I had to do. It takes me 8 weeks of work for what could have been squashed day one if the system were not broken.
It’s coming to a point where the easier thing to do is basically nothing for the patient, and we wonder why the ER is packed. People see 16 specialists, people seek second, third or fourth opinions, further delaying care. I hate this.
[The most frustrating aspect of prior authorization is] the delay in care or the denial of care that a patient needs. It should not be this difficult to provide care. Seems strange that someone not in the medical office with the patient is deciding what the patient needs or does not need after a physician that has had a decade of training makes a recommendation.
This happened to my sweetheart, changing insurance companies. He was on pain meds for an extended period and they wouldn’t authorize his meds in time so his current prescription ran out and we had to go to the hospital for pain control. They are heartless!!
If my insurance wants a prior authorization, forget it, it will not happen. One day my doctor tried and his staff spent 6 hours on the phone for one patient. No one has that kind of time. PRIOR AUTHORIZATION MUST BE FIXED!
We have patients who have paid insurance for years, need spine surgery for pain, and because they don't meet criteria they are denied.
I have 6 full time and 1 part time staff to support 1 physician and 1 physician assistant. They spend so much time with PA's and insurance issues that we struggle to answer the phone when a patient calls. It leads to frustration on everyone's part. It's getting worse, please help!