Discover and read the best of Twitter Threads about #PriorAuth
Most recents (4)
Here’s the dirty secret of emergency medicine:
We don’t have to do prior auth. Like ever. We just order what the patient needs, and the patient gets it done in the ED.
But here’s why we care about prior auth anyways:
B/c not a shift goes by where a patient doesn’t land in the… twitter.com/i/web/status/1…
We don’t have to do prior auth. Like ever. We just order what the patient needs, and the patient gets it done in the ED.
But here’s why we care about prior auth anyways:
B/c not a shift goes by where a patient doesn’t land in the… twitter.com/i/web/status/1…
Need your gallbladder taken out electively? Too late (waiting for auth), now you’re in the ED with cholecystitis.
Had a “nodule” seen on a CT, but couldn’t get a repeat scan authorized…ever? Now it’s metastatic and you’re in the ED for crippling pain.
DVT? No problem, started… twitter.com/i/web/status/1…
Had a “nodule” seen on a CT, but couldn’t get a repeat scan authorized…ever? Now it’s metastatic and you’re in the ED for crippling pain.
DVT? No problem, started… twitter.com/i/web/status/1…
Why does this matter?
1. It’s terrible for patients
2. It stresses the healthcare system in ways it shouldn’t
3. It’s cumbersome and wasteful to insurers and clinicians both
1. It’s terrible for patients
2. It stresses the healthcare system in ways it shouldn’t
3. It’s cumbersome and wasteful to insurers and clinicians both
So what are #PBMs? Chances are, if your meds suddenly got changed by your insurer, or you’ve been waiting weeks on #priorauth for a med you need, or you pay $$$$$ for a drug in the US that is cheap overseas, you’ve already experienced a #PBM and didn’t even know… twitter.com/i/web/status/1…
That’s b/c #PBMs aren’t meant to be known, they’re meant to be a middleman in healthcare cutting in an extra layer of profit for them and an extra cost to you…wonder why #prescriptiondrug pricing makes no sense compared to prices in other countries? This is why.
Pharmacy Benefit Managers (PBMs) are third party entities paid by healthcare insurance companies to manage all things meds: the formulary (what is/isn’t covered), the price from manufacturer, and the cost (copay or “tier”) to the patient.
Today is National Physician Suicide Awareness day. #NPSADay
A couple of issues drive problems with physician mental well-being:
- Job-associated burnout
- Stigma and harm associated with seeking help (having to report this condition on your license, and to your hospital)
A couple of issues drive problems with physician mental well-being:
- Job-associated burnout
- Stigma and harm associated with seeking help (having to report this condition on your license, and to your hospital)
What I find interesting are the responses you get from physicians when you ask about what actions can be taken to reduce burnout. Not shorter hours / more pay.
- Reducing low-value work & EHR clicks
- Eliminating insurance barriers like #PriorAuth
- Reducing low-value work & EHR clicks
- Eliminating insurance barriers like #PriorAuth
These factors don't just affect physicians. Nurses, RTs, MAs, CNAs & more are harmed.
We are in a work-force crisis. We should be looking to protect the people we have.
Forget the mindfulness exercises.
Reduce EHR burdens.
Reduce box-checking.
#FixPriorAuth.
@MedicineForward
We are in a work-force crisis. We should be looking to protect the people we have.
Forget the mindfulness exercises.
Reduce EHR burdens.
Reduce box-checking.
#FixPriorAuth.
@MedicineForward
1/ @AmerMedicalAssn submitted comments to @CMSGov regarding a NPRM on provider burden reduction and #priorauthorization: tinyurl.com/y5ebobkf
The NPRM cited #OurAMA prior authorization survey data and grassroots website FixPriorAuth.org
The NPRM cited #OurAMA prior authorization survey data and grassroots website FixPriorAuth.org
2/ The rule proposes policies to help make the prior authorization process more efficient and transparent.
The NPRM would require #Medicaid, CHIP, and federally facilitated health exchange plans to:
•Support technology that would convey #priorauthorization requirements
The NPRM would require #Medicaid, CHIP, and federally facilitated health exchange plans to:
•Support technology that would convey #priorauthorization requirements
3/ The NPRM would also require impacted payers to:
•Automate the exchange of supporting clinical data from physicians’ #EHR workflow
•Publicly report data on #priorauthorization programs and comply with processing timeframes
•Automate the exchange of supporting clinical data from physicians’ #EHR workflow
•Publicly report data on #priorauthorization programs and comply with processing timeframes
