decisionhealth Newsletters, Part B News - 2019 Issue 2 (February)
Prior authorization still a problem; wait for standards change or get help
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Article Overview
This article explains why prior authorization remains a major administrative and clinical challenge for practices, based on an AMA survey, and summarizes broader efforts to improve transaction workflows. It is relevant to billing, practice management, and revenue cycle professionals who want to understand current workflow friction, payer communication standards, and the role of vendor platforms in supporting prior authorization processes.
Why This Topic Matters
Prior authorization affects practice efficiency, patient access, and administrative workload, and the article highlights both reported harm and ongoing workflow modernization efforts. Readers can use it to gauge whether standards changes or outside tools may help reduce manual effort in their own operations.
What You Will Learn
- How a recent AMA survey characterizes prior authorization burden in medical practices
- What industry groups are doing to improve prior authorization transaction workflows
- How vendor-supported authorization management platforms are positioned in the market
- Why specialty medication authorization remains especially operationally complex
Who Should Read This
- Medical billers
- Coders
- Revenue cycle staff
- Practice managers
- Healthcare administrators
- Payer relations staff
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