QI
President’s Letter
From Our President
We Need You: Tell Your Prior Authorization Stories Almost all of us have practiced medicine with the onerous process of prior authorization. In my own practice, it is routine to call an insurance company and have a member of my staff sit on hold for up to 45 minutes, only for me to end up on the phone with a nurse or physician who is not board-certified in orthopaedics determining the fate of my patients’ care. Let’s assume for a moment that the decision to implement this process years ago was one made in good faith with financial responsibility in mind. Even then, I know none of you or your staff have time to sit on hold during a busy clinic day while patients wait for the approvals to come through. I know of one of the larger practices in our community that has 5-6 FTE’s exclusively dedicated to handling prior authorization requests. How is this good for the healthcare system and for our patient care?
In most cases for me, and I’m told by many others, the case goes on to be approved anyway. And when they’re denied, we often appeal, which delays the process even more. This often leads to worsening of our patients’ medical condition. I applaud the TMA for deciding to take on this important issue in medicine. This effort represents what we should be doing to support our physicians who are constantly striving to promote the best outcomes for their patients And now, we need you and your practice to act. We need you to scan the QR code below with your phone’s camera and tell your prior authorization story. It is a short form and easy to fill out. You can be as brief or descriptive as you want in your narrative. You can also have TMA staff reach out to you for more detailed information. I encourage you to check that box. If we flood the legislature with these important patient stories, it will encourage them to take action on behalf of the constituents they serve. Visit this link, or scan the code with your phone: https://form.jotform.com/213466158677164
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