[Prior authorization affects my practice because] it delays patient care. The process is tedious, and the insurance companies are programmed to deny first. You are on the phone for hours waiting and when you finally reach someone, they often redirect you to another department or team where you have to wait again. The operators don't know or understand the procedure or what the patient needs to authorize something. They also can't answer your questions because they are not clinical. The insurance companies have hard and fast rules that do not take the patient into account. They will still deny procedures even when their own medical experts agree with your assessment and what the patient needs. "If the plan doesn't cover it, then there's nothing they can do." The entire process is burdensome and harms patient care.