LINCOLN — Its a question that doctors and patients have been asking for years.
How do you deal with the middleman that is insurance and the prior authorization process?
“It’s a big part of what’s driving healthcare costs in this country,” said Jeremy Nordquist with the Nebraska Hospital Association.
Physicians have to do a lot of prior authorizations.
Harvard Medicine estimates that on average every physician is pending about 12 hours a week just on prior authorizations.
The back and forth between doctors and insurers isn’t just an inconvenience, it takes valuable time away from doctors that could be seeing patients and Nordquist warns its burning out health care professionals.
“We hear from them all the time and we think it’s compounding our workforce issue. We have doctors and nurses say at the end of the day im not gonna continue when I need to spend 20, 30, 40 percent of my time jumping through hoops. I want to be here to provide,” said Nordquist.
Nordquist and the Nebraska Hospital Association are hoping a new bill, LB77, will help cut through some of the headache that prior authorizations bring.
The bill would require insurers to respond within a day to prior authorizations of an urgent need, or two days for not urgent requests.
The bill isn’t just laying out timelines either, it’s trying to tackle another big issue with prior authorization insurers letting unqualified doctors decide whether certain care is necessary.
“When an insurance company denies care to a patient and a provider has to take time to get on the phone with someone and appeal that denial, that whoever is on the phone has equal educational background,” said Nordquist.
