Changing the Game of Prior Authorization

In this Viewpoint, Berwick and colleagues review the evolution of prior authorization ( “prior auth”) into a process where insurers deny previously approved coverage, patients receive surprise bills, and clinicians spend time appealing charges, and propose the introduction of legal provisions that make authorization decisions binding and absolve patients, clinicians, and organizati on of financial responsibility for previously approved services.
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research