I work at a urology practice. When I started here the only procedures requiring prior authorizations were surgeries. Now medications, radiology, and in-office procedures require prior authorization or you do not get paid. Often new prior authorization requirements are buried deep within some emailed network bulletin. Insurers are famous for changing prior authorization requirements. They just started requiring us to request prior authorizations on all chemo medications injected or infused through a portal. The questions are often confusing and time consuming even to the physicians. We have had patients that have had to put off certain treatments because it takes so long to get a prior authorization back or the hoops we have to jump through are increasingly tedious.
Robin S., Georgia