I work in healthcare and prior authorization is the biggest waste of time and money. As it’s been said, they have a person sitting in a cubicle somewhere who doesn’t know you, who has never met you, determining if you need the testing, procedure or medication your doctor has ordered. A doctor’s office has to provide chart notes and CPT and ICD10 codes. This can take days and sometimes weeks and sometimes an appeal before an authorization is given. Ironically, after all this time wasted and patients waiting sometimes in pain or worry about a lump/tumor/cyst....the insurance company states that prior authorization doesn't guarantee payment and benefits are determined when a claim is received. So by their own words prior authorization is meaningless yet without it they won’t pay. Prior authorization is supposed to prevent unnecessary treatment which by the way still happens in spite of this rule. . . . There is entirely too much power given to insurance companies and pharmaceutical companies as well. These huge corporations are bonus driven....whenever a company is for-profit and bonus driven, the best interest isn't for those they work for; they only watch out for themselves. It’s not about patients...we are just a # to them....it’s the bonus that matters. We need insurance to pay for the services we need...quit raising premiums and giving us less coverage!! Deductibles and out of pocket and even copays have gone up.

First Name: 
Linda
Last Name: 
J.
State: 
State
E-mail address: 
Linda J.
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 for days, weeks, or months for a test or medical procedure to be scheduled because authorization from an insurer? Or are you a physician frustrated with the administrative headaches and their impact on your patient?

Prior authorization is a burden on patients and physicians alike. The process is confusing, time consuming, and — most importantly — can cause delays in patients receiving the care they need.

Please tell us know how prior authorization has impacted you. We are looking for stories from patients and physicians to highlight and draw attention to this issue that is impacting the health of so many Americans.