Dr. Eric Bricker Explains the Prior Authorization Process Doctors, Hospitals and Facilities Go Through With Insurance Carriers to Have Certain Tests and Procedures Covered.

Health Insurance Carriers Contract Out Prior Authorization to Vendors Such as 1) Evicore, 2) AIM Specialty Health, 3) NIA (Owned by Magellan) and 4) Health Help.

Prior Authorization is Typically Required for Advanced Imaging (CT Scans, MRIs, PET Scans), Cardiac Imaging (Stress Tests, Echocardiograms), Cancer Treatment, Orthopedic Surgeries and Sleep Studies.

Traditional Medicare Has NOT Had ANY Prior Authorizations Required Until Recently Putting in 'Appropriate Use Criteria' for Some Imaging.

The Process of Prior Authorization is Cumbersome, ErrorProne and TimeConsuming for Doctors and Patients and Some Physician GroupsSuch as the American College of CardiologyAre Fighting Back.

Sources: https://www.myndshft.com/theultimate...

Disclosure: Dr. Bricker is the Chief Medical Officer of Virtual Care Company First Stop Health.

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