Centrala begrepp
Prior authorization delays in radiation oncology impact patient care and increase administrative burden.
Sammanfattning
The content highlights the challenges faced by radiation oncologists due to prior authorization delays, focusing on the impact on patient care and the increasing administrative burden. Key points include:
- Radiation oncologist Vivek Kavadi's experience with prior authorization delays for a standard radiation treatment.
- The commonality of prior authorization requirements in radiation oncology, affecting patient care.
- The significant costs and time associated with handling prior authorizations, including staff hiring and appeals.
- The frustration and burden felt by healthcare providers due to delays in patient care.
Statistik
One recent analysis estimated that 97% of radiation oncology services now require prior authorization under Medicare Advantage.
Vanderbilt's radiation oncology department spent nearly $500,000 annually in employee time to obtain prior authorization for radiation therapy treatments.
Data from the Texas Oncology network indicate that for every five doctors, there is one full-time employee dedicated to prior authorization.
The network spends about $960,000 per year on full-time prior authorization employees.
Citat
"I chose the most cost-effective, standard treatment, but nothing could begin without the insurance company's permission." - Vivek Kavadi, MD
"We would love to start, but your insurance company has not given us approval. The best I can do is give you a tentative appointment." - Vivek Kavadi, MD
"This is an example of a process that has run so far amok. It's just a burden across the board." - Vivek Kavadi, MD