Prior authorizations lead to delays in retina care: Study

The majority of prior authorizations for ophthalmology patients seeking anti-vascular endothelial growth factor medications have been linked to delays in care, according to a June 27 study published in JAMA Ophthalmology. 

Advertisement

The study looked at nine retina practices and 2,225 prior authorization requests across the U.S., finding that 96% of prior authorizations for medications were approved. 

The prior authorizations were also associated with a delay in care, and each authorization required a median of 100 minutes of clinic staff time. 

Anti-vascular endothelial growth factor intravitreal injections are a mainstay of treatment for many retinal diseases to optimize visual outcomes. 

Of the 2,140 prior authorization approvals, 59.6% resulted in a delay in care greater than 24 hours, and 40% were given on the date of service.

Of the delayed approvals, 23.9% were approved within one day, 15.9% were approved within two to three days, 21.5% were approved within four to seven days, 26.3% were approved within eight to 31 days and 12.4% were approved within more than 31 days.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Building a High-Performance Cardiac PET Program: What Health Systems Should Consider

Thursday, July 30
12:00 PM - 1:00 PM CDT

Presenters: Rupa Sanghani, MD, FACC, FASNC, Rush University Medical CenterBrendon Loiselle, CDL Nuclear Technologies

Advertisement

Next Up in Ophthalmology

  • East Lansing-based Michigan Surgical Center has disclosed a data breach that may have exposed personal information, according to a July…

  • Cincinnati-based MidWest Eye Center welcomed Alec Bradley, MD, an ophthalmologist who specializes in premium cataract surgery, refractive surgery, microinvasive glaucoma…

Advertisement

Comments are closed.