Prior Authorizations & Claims Denials: What’s Changing?

Healthcare providers want to get the right care to the patient as quickly as possible, and health plans want to ensure treatment choices are appropriate, legitimate, and cost-conscious. Yet, prior authorizations and claims denials are complicated and can delay critical care. In fact, the AMA reported that 940:1,000 providers saw delays in care due to prior authorizations (PA) and eight in ten said their patient abandoned treatment while waiting. Their research indicates that claims denials and reimbursement delays stemmed from prior authorization issues. 

What is the problem and what is being done to streamline the PA process and expedite authorized care?