In the organization’s 2021 survey, nearly two-thirds of respondents, 62%, said it is at least somewhat difficult to determine if a medical service requires prior authorization. Part of that time burden, according to AMA survey respondents, is due to how challenging it can be to even determine if a patient’s plan requires prior authorization for a specific test, procedure or medication. Gabe Charbonneau, a Montana family physician and co-founder of the grassroots organization Medicine Forward, which along with the American College of Physicians has made addressing prior-authorization its cornerstone issue.
“That’s time that we, frankly, just don’t have,” said Dr. Nearly two in five physicians said they have a staff member solely dedicated to prior authorization. According to the AMA survey, physicians and their staffs spend an average of 14 hours, or nearly two business days, processing prior authorization requests and any associated appeals.
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