The proposal requires certain payers to address the administrative hassles of prior authorization by requiring the implementation of an automated process, meeting shorter time frames for decision-making and improving transparency.
Some surgeons, including Lali Sekhon, MD, PhD, a spine and neurosurgeon at Reno (Nev.) Orthopedic Center, are still skeptical that CMS’ proposals will become reality and are waiting to see actual changes and results.
Dr. Lali Sekhon: The proof of the pudding will be the eating. Just like hospitals and transparency of billing, payers will do all they can to avoid this, confuse this and mitigate delays/denials/deferrals to make the end-of-quarter balance sheets look better.
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