Here’s How Alabamians Can Fight Insurance Red Tape That Delays Medical Care

Alabama doctors and patients frustrated with delays in care caused by insurance companies’ prior authorization process now have a new way to share their stories and promote change.

A new online platform — www.ALFixPriorAuth.com — invites Alabamians to share their experiences with prior authorization problems. The website and the initiative behind it to encourage faster insurance approvals for medical care was started by doctors with the Medical Association of the State of Alabama.

Doctors say delays caused by prior authorizations can have dangerous impacts on their patients’ health.

>>>Watch this video: Doctors Discuss the Burdens of Prior Authorization<<<

“With prior authorizations, we definitely see a delay in patient care,” said Dr. Tonya Bradley, a physician in Auburn. “I see delays in patients getting chemo, I see delays in patients getting tests they need to diagnose problems that can be very urgent.”

What is Prior Authorization?
Before your doctor provides a treatment, your insurance requires them to prove you need it. Decades ago, prior authorization was used sparingly and typically only to make sure some expensive treatments were absolutely necessary.

But today, even routine medical care requires insurance approval. Denials mean patients and doctors must spend time fighting insurance companies for care.

Takes Time Away From ‘What Really Matters’
When doctors have to spend time arguing with insurance companies over prior authorizations, it means there’s less time for doctors to spend with their patients – their number one priority.

“The bureaucracy. The paperwork. The institutional inertia. The list goes on and on, and it makes it very difficult for us to do what really matters, which is take great care of our patients,” said Dr. George Koulianos of Mobile.

What Alabamians Think
A survey of Alabama doctors found that 76 percent said the time they spend on prior authorizations means they see fewer patients in a day. One-third of doctors said they and their staff spend nearly an entire workday each week filling out prior authorization paperwork, following up with phone calls and fighting denials.

A separate survey of 500 Alabamians showed that 80 percent agree with the statement that “doctors in Alabama are working to spend more time with patients, so that patients and doctors have the time together to make the best health care decisions.”

Dr. Hernando Carter said being able to spend more time with patients rather than prior authorizations results in better health care.

“If you can spend the time to explain to your patient why you’re recommending a test or why you’re recommending a treatment and be able to answer all the questions they have and assuage any concerns or apprehensions they have, then that directly affects how well they do. It directly affects whether they get better or not,” the Birmingham physician said. “So, we abhor anything that interferes or cuts into that time that we have to do that with our patients.”

“We need to have the ability to take care of our patients in an efficient manner, expedite the care and not go through all the red tape,” said Dr. William Admire of Mobile. “When we slow down the progress of patients’ recovery, no one wins.”

Steps to Fix Prior Authorization
Physicians with the Medical Association have begun conversations with the health insurance community to push for changes. Stories submitted through www.ALFixPriorAuth.com will help support efforts to fix prior authorization in Alabama.

Among the changes doctors want to see are an end to repeat prior authorizations for patients with chronic conditions and faster response times from insurers.