DAILY UPDATE: Prior Medical Authorizations Up as Stock Markets Rise to Record Highs!

By Staff Reporters

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A new set of rules from the Biden administration seeks to rein in private health insurance companies’ use of prior authorization – a byzantine practice that requires people to seek insurance company permission before obtaining medication or having a procedure. The cost-containment strategy often delays care and forces patients, or their doctors, to navigate opaque and labyrinthine appeals.

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 52.42 points (1.1%) to 4,958.61, up 1.4% for the week; the Dow Jones Industrial Average gained 134.58 points (0.4%) to 38,654.42, up 1.4% for the week; the NASDAQ Composite rallied 267.31 points (1.7%) to 15,628.95, up 1.1% for the week.
  • The 10-year Treasury note yield (TNX) surged about 16 basis points to 4.024%.
  • The CBOE Volatility Index® (VIX) fell 0.04 to 13.84.

The market’s strength continued to be driven by the biggest companies, while smaller names lagged. The small-cap Russell 2000® Index (RUT) fell 0.6% Friday and posted a drop of 0.8% for the week. In other markets, the U.S. dollar index (DXY) rose 0.8%, reaching its strongest level in nearly two months, amid expectations interest rates will remain elevated, which boosted demand for dollar-denominated assets, such as Treasuries.

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PODCAST: Health Insurance Prior Medical Authorization Rates Are Down

BUT MEANINGFUL?

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource

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PODCAST: How Medical Prior-Authorization Really Works

Pre-Certification Works OR Doesn’t Work

BY ERIC BRICKER MD

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Medical Practice “Prior Authorizations”

THE “SIREN CALL” OF MEDICAL PRACTICE PRIOR AUTHORIZATONS

Courtesy: www.CertifiedMedicalPlanner.org

“The Doctor Can’t See You – She’s Too Busy Doing Prior Authorizations.”

By Dr. David Edward Marcinko MBA

Somewhere along the way, physicians took a wrong step. Colleagues said OK to the SERPENT who whispered: “this saves money,” and now we’re entangled. We should’ve asked, “Whose money?”

PRIOR AUTHORIZATIONS for medical treatment and prescription drug are killing medicine and all those who would follow into this once great profession.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

And so, here is an excerpt [blinded and abbreviated] from an email we received from a medical physician colleague.

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DOCTOR: For every hour that I spend with a patient, I spend another three hours documenting and begging.
TYPICAL DAY: 4 hours of seeing patients, sprinkled between 12 hours of doing what we used to call “paperwork”.

EMRs: Calling it Electronic Medical Records and data collection doesn’t make this nonsense any more appealing.
ASSESSMENT: Patients get turned away because PCPs are too busy with paperwork. People are sick and dying while I’m calling clerks and pleading for RXs. I’d rather be doctoring.
BOTTOM LINE: 1/5 of my day, over 12 hours a week as a PCP, is now spent on prior authorizations. 1/3 of my assistant’s day is on prior authorizations. That’s why he couldn’t call you back.

CONCLUSION: Next time you can’t get a doctor’s appointment, you’ll know why.

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Assessment: Your thoughts and comments are appreciated.

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