pprior approval for ct

Why aren’t we charging the payors for prior approval on ct scans?   This is an expensive time consuming service we are providing for free , why? 

  I’m going to start charging $200 per approval.   If it costs enough they’ll quit.

                John Peterson MD

 
 

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2 Comments

  • Mark R. Cervi, MD

    I have to feverishly agree with Dr Peterson’s comments regarding charging the third-party payors for the amount of time spent doing prior authorizations on CT/MRI/Angios,etc. I have had to hire a part-time staff person just to help handle these tasks and to keep patient flow without the proverbial “check-out” stenosis! Why have we let the insurance companies become the tail wagging the dog????

  • Linda S. Winegardner, MD

    Dr. Peterson,

    We view it as increasing the complexity and time required for care (e.g. a bump up on the E&M?). Our doctor is directly involved in getting the approval and thus directly involved in the patient care. Result is fewer patient encounters – less productivity – less revenue = go out of business! There should be an increase in reimbursement for this additional administrative requirement. If we are busy and don’t have time for the authorization process, we send the patient to an appropriate specialist (ortho/GI). Costs insurance more but that is a consequence of the insurance company policy. We have many cases where this insurance company policy drives up cost for all and reduces the quality of care.

    Vince Winegardner
    Practice Manager