The Insurance Approval Process for Proton Radiation Therapy: A Significant Barrier to Patient Care

To shed light on the insurance approval process for proton radiation therapy, our study follows 903 patients who entered the process at a large volume proton therapy center, demonstrating significant treatment delays (median 21 days with appeal) associated with obtaining authorization. Furthermore, while insurance type reliably predicts for approval, several clinically-relevant factors may not be actively considered in coverage determinations, including trial enrollment, indication, and site, with overall approval rates decreasing over time.

Source: International Journal of Radiation Oncology * Biology * Physics - December 14, 2018 Category: Radiology Authors: Matthew S. Ning, Daniel R. Gomez, Aashish K. Shah, Charissa R. Kim, Matthew B. Palmer, Nikhil G. Thaker, David R. Grosshans, Zhongxing Liao, Bhavana V. Chapman, Eric D. Brooks, Chad Tang, David I. Rosenthal, Adam S. Garden, Steven J. Frank, G. Brandon Gun Tags: Clinical Investigation Source Type: research