2021 Annual Meeting Startup & Practice Management Access Pass-Congressional Updates That Will Affect You: Surprise Billing, Pre-Certification and E&M

Congressional Updates That Will Affect You: Surprise Billing, Pre-Certification and E&M

Video Transcription

Video Summary

The discussion explores prior authorization, a process insurers use to approve medical services before coverage, often seen by providers as a barrier causing denials and delays. It highlights the significant administrative burden and costs, with denial rates varying widely. Prior authorization has expanded from commercial insurers to Medicare Advantage and Medicaid. Studies show it can save costs but may delay necessary care, leading to higher expenses later. Proposed solutions include exempting trusted providers, sunsetting ineffective authorizations, and increasing automation. The Improving Seniors' Timely Access to Care Act aims to standardize electronic prior authorizations, increase transparency, and reduce unnecessary denials, with bipartisan support expected.

Asset Caption

Dr. Eric Stiefel

Keywords

prior authorization

insurance approval

medical service delays

administrative burden

Improving Seniors' Timely Access to Care Act