One of the missions of health insurance providers is to ensure patients have access to effective, quality, evidence-based care. Clinical practice guidelines support the practice of evidence-based medicine, and are typically derived from recognized scientific sources such as specialty societies and are updated annually.
Managing Prior Authorization
"It's an occupational hazard now. I've been diagnosed with 'Prior Authorization Elbow.'"
Despite recent moves to streamline the prior authorization process, physicians still struggle mightily as they jump through payers’ hoops.
An inside look at what drives insurers to refuse to negotiate, require more prior auths and deny claims
Physicians should focus on generating revenue, not putting in a longer workday, experts say
How approval hassles for ordering tests or prescribing drugs can get in the way of caring for patients.