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Arbitrary. Confusing. Frustrating. Never-ending. Maddening. Those are some of the terms we can actually print that describe physicians’ experience with insurance companies’ prior authorization requirements and approval processes.
Your personal stories of the impact of prior authorization requirements on your practice and patient care – including any patient harm due to prior authorization request delays or denials – can give the Texas Medical Association the ammunition it needs to fight this problem.
According to a recent American Medical Association survey, 94% of physicians report prior authorization delays access to necessary care.
But this is more than a doctor’s office hassle. Patients are paying the price with their health. In that same survey, a majority of physicians (78%) reported patients abandoning treatment due to prior auth delays, and 1 in 4 said the practice led to serious adverse outcomes for patients, including death, hospitalization, or permanent injury.
TMA has made progress over the years with the passage of the "gold card" prior auth exemption law, and continues to fight for wholesale reform.
That’s where you come in. TMA wants to collect your ongoing prior authorization nightmare stories to share with stakeholders and continue to drive change.
Please submit your stories via TMA’s secure email portal. Before submitting your story to us, it is important for you to ensure that your story submission complies with state and federal laws, including, to the extent applicable, the HIPAA privacy rule. HIPAA’s safe harbor list of 18 de-identification requirements, in accordance with Code of Federal Regulations, is available here.
Last Updated On
November 06, 2024
Originally Published On
December 08, 2023
Amy Lynn Sorrel
Associate Vice President, Editorial Strategy & Programming
Division of Communications and Marketing
(512) 370-1384