Most medical students understand that a good chuck of their day as practicing physicians will involve clicking through electronic health records and completing paperwork. But I do not think it is ever made clear how often we will interact with insurance companies. Of course, this will vary by specialty, but everyone entering medical practice should have a basic understanding of prior authorization.
I recently saw an Instagram post from Dr. Austin Chaing about the frustrations of prior authorization — a process wherein medical care will only be paid for if it has been pre-approved by the insurance company. There are a number of reasons insurance companies require preauthorization, including age, medical necessity, and availability of a generic. If a prior authorization is denied, a healthcare provider may file an appeal based on their assessment of the patient and the recommended treatment or medication.Continue reading “The Frustration of Prior Authorization and What It Means For Burnout”