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Is Time Spent on Prior Authorizations Associated With Approval?

Published:November 10, 2022DOI:https://doi.org/10.1016/j.nurpra.2022.10.008

      Highlights

      • Advanced practice providers assume the responsibility for prior authorization.
      • Prior authorizations can be tedious and burdensome to navigate.
      • Prior authorizations have inconsistent intended outcomes for patients and providers.
      • Fewer prior authorizations can improve practice efficiency and patient outcomes.

      Abstract

      Advanced practice providers increasingly assume responsibility for prior authorizations (PAs). We hypothesized that the time burden of PAs will be correlated with increased approval. We collected several variables (ie, type, method, time spent, use of peer to peer, and outcome) for all PAs completed by a departmental nurse practitioner in 1 region. Chi-square tests and 2 sample t tests were used to assess significance. There was no significant association between the method of request, the number of attempts, and the time spent to approved PA. Further research is needed to determine ways to decrease the time and opportunity cost associated with PAs.

      Keywords

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      References

        • Resneck Jr., J.S.
        Refocusing medication prior authorization on its intended purpose.
        JAMA. 2020; 323: 703-704
        • Quallich S.A.
        The price of prior authorization.
        Urol Nurs. 2015; 35: 109-110
        • Robeznieks A.
        Prior authorization is a major practice burden. How do you compare?.
        • Sugarman Y.A.
        Prior authorization reform remains a top priority for urology community.
        • Sharma S.P.
        • Russo A.
        • Deering T.
        • Fisher J.
        • Lakkireddy D.
        Prior authorization: problems and solutions.
        JACC Clin Electrophysiol. 2020; 6: 747-750
        • AMA
        AMA adopts new policies to rein in prior authorization burdens.
        • Casalino L.P.
        • Nicholson S.
        • Gans D.N.
        • et al.
        What does it cost physician practices to interact with health insurance plans?.
        Health Aff (Millwood). 2009; 28: w533-w543
        • Yang E.
        • Yang S.
        Prior authorization: overwhelming burden and critical need for reform.
        JACC Case Rep. 2020; 2: 1466-1469
        • Soares M.O.
        • Sculpher M.J.
        • Claxton K.
        Health opportunity costs: assessing the implications of uncertainty using elicitation methods with experts.
        Med Decis Making. 2020; 40: 448-459
        • Carlisle R.P.
        • Flint N.D.
        • Hopkins Z.H.
        • et al.
        Administrative burden and costs of prior authorizations in a dermatology department.
        JAMA Dermatol. 2020; 156: 1074-1078
        • US Bureau of Labor Statistics
        Occupational employment and wage statistics.
        • Decapua M.
        How much revenue does a primary care nurse practitioner generate?.

      Biography

      Vinayak Madhusoodanan, MD, is a Urology Resident at Desai Sethi Urology Institute, Miller School of Medicine, University of Miami in Miami, FL.

      Biography

      Libert Ramos, DNP, is a Advanced Practicing Registered Nurse at Desai Sethi Urology Institute, Miller School of Medicine, University of Miami.

      Biography

      Isaac J. Zucker, MS, is a Medicine Student at Desai Sethi Urology Institute, Miller School of Medicine, University of Miami and the Herbert Wertheim School of Medicine, Florida International University in Miami, FL.

      Biography

      Aditya Sathe, BS, is a Medical Student at the College of Medicine, University of Tennessee Health Science Center in Memphis, TN.

      Biography

      Ranjith Ramassamy, MD, is the director of Male Reproductive Medicine at the Department of Urology, University of Miami and can be contacted at [email protected] .