Delays in prior authorizations in terms of surgical scheduling can be one of the toughest and most overlooked challenges when it comes to running an orthopedic practice, according to these physicians.
Three orthopedic surgeons connected with Becker’s to share how they deal with prior authorization delays.
Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting orthopedic care. Becker’s invites all orthopedic surgeon and specialist responses.
Next question: What is one inefficiency in your practice that you’re actively working to fix?
Please send responses to Cameron Cortigiano at ccortigiano@beckershealthcare.com by 5 p.m. CST on Sept. 22.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How are you navigating prior authorization delays in surgical scheduling?
Ronald Gardner, MD. Founder of Gardner Orthopedics (Fort Myers, Fla.): We try to prioritize along acuity of need and make the greatest effort where needed. Sometimes, though not often, getting the patient involved helps. There is only so much bandwidth that makes sense to use, so for some procedures/items, we no longer offer them for certain carriers, which might be considered a victory for certain third-party payers.
David Kugelman, MD. Joint Replacement Surgeon at Rothman Orthopaedics (Philadelphia): At Rothman, we’re fortunate to have a dedicated and efficient prior authorization team that helps minimize delays and ensures continuity in surgical scheduling for our patients.
Madhish Patel, DO. Orthopedic Surgeon at Gardner Orthopedics (Fort Myers, Fla.): This is one of the challenging aspects of a surgeon’s practice. Being patient advocates, anticipating this delay and providing the necessary documentation helps expedite this process. More importantly, counselling and communicating this possibility with patients before-hand helps in both satisfaction scoring and reducing the patients’ stress that comes along with it. I believe it is an administrative burden that is neither fully appreciated nor considered when calculating reimbursement rates/compensation for orthopedic practices.
