Prior authorizations required by many insurance companies can keep patients from getting the medical supplies they need, according to NPR.
Ric Peralta, a patient with Type 1 diabetes, told NPR of a time he tried to order a new supply of sensors for his Dexcom continuous glucose monitor and his claim was denied because of a small clerical error made by Dexcom. The error caused him to go a month and a half without the device, which allows him to manage his diabetes without having to prick his fingers for blood every few hours.
Because Mr. Peralta needs prior authorization from his insurer every three months when he orders a new supply of sensors, he is consistently at risk of a similar situation preventing him from accessing the device that makes his disease manageable.
"If I do not have my proper management of this disease I'm going to die from it. And they're making it as difficult as possible," Mr. Peralta told NPR.
A 2018 survey of 1,000 physicians by the American Medical Association showed that prior authorizations are a major concern of physicians across the U.S.
Ninety-one percent of the surveyed physicians said prior authorizations have a negative effect on patient clinical outcomes. Seventy-five percent said requirements can at least sometimes lead to patients abandoning a recommended course of treatment, and 28 percent said the prior authorization process led to serious or life-threatening events for their patients.
Read the full article here.
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