Prior Authorization Agony

Don't 'throw everything at it' before examining reasons why patients don't arrive for treatments.

Medicaid work requirements, new remote monitoring rules and an electronic prior authorization deadline all land Jan. 1, and that's only part of what MGMA told practice leaders to watch.

Hold times, delayed approvals and denials on authorized care dominated member feedback to MGMA's government affairs team.

MGMA is pushing back on any delay as insurers describe a three-step build.

A delay would leave practices without the information they need to train staff and test workflows before the deadline, the AMA told CMS.