PRESIDENT'S MESSAGE

Prior Authorization and You

Have you ever experienced this? Your patient needs a certain procedure to evaluate or manage their condition. It’s clear this procedure is needed, but you and your patient need to jump through administrative hoops to get prior authorization. You spend your time going above and beyond to advocate for your patient by researching the latest evidence-based data, documenting the medical necessity and including the appropriate ICD-10 codes--only to argue with a peer reviewer instead of actually treating your patient.

I didn’t go into medicine to argue about something as simple and clear cut as my patient getting the care they need. My guess is that you didn’t either. Being forced to spend time away from direct patient care is one of the leading reasons we physicians are suffering from burnout. Rather than using our years of training, we get caught in the authorization loop.  

The California Medical Association (CMA) requests input on how prior authorization protocols have affected you or your patients. This is a chance to funnel your frustration into advocacy to combat one of the many sources of burnout. 

Advocacy is one of the many ways we can take back control of our practice and make things better for our colleagues.  

Share your stories of prior authorization difficulties with CMA below.

If you are experiencing symptoms of burnout, please access SSVMS’s Joy of Medicine Program. You can find these resources here. 

J. Bianca Roberts, MD

SSVMS President

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