The Prior Authorization (PA) process has become so arduous that practice management experts offer tips that include performing a cost-benefit analysis of the top payers in the practice to determine how many PAs they required over the past year and consider dropping those who create the most administrative waste. The experts also recommend physicians learn which drugs are covered on each of the plans they are contracted through and to write for generic drugs whenever possible — great advice, but obviously provided by someone who does not practice clinical medicine!
Over the past three years, there has been a significant increase in the number of PAs required by insurance carriers, even for generic medications that have been available for over a decade. Often, these medications are available for a fraction of the cost by avoiding insurance altogether and paying cash. Patients have the option of using free consumer applications, such as GoodRX, using discounts offered by Wal-Mart without coupons or memberships, or purchasing a discount membership directly through many pharmacies like the one Kroger offers where a $36 annual membership fee provides a discount on many popular generic prescriptions, some of which are free with the membership.
Current data demonstrates the PA process is not only burdensome for the physician and medical staff but may also lead to poor outcomes for patients through delays in approval or insurance coverage denials. To improve care and patient safety, all physicians should be aware of alternatives for patients in obtaining necessary medications and share these with their patients. Patients should also be mindful that sometimes it is more cost effective and expedient to leave their insurance card at home and pay cash for many of their prescriptions.
I guess the practice management experts forget to mention that? But their slides were sure pretty.Tweet