This is not good! Is this across the entire enterprise?
7 replies (most recent on top)
@jj What?
Is this why there bringing counterpart?
@OP Prior auths across the enterprise?
The elimination of these PA requirements won’t affect core insurance ops much because these outpatient services are rarely reviewed internally but rather farmed out to various companies that review radiology and procedure requests such as Cohere, health help, etc.
"July 22 (Reuters) - Humana said on Tuesday it would eliminate about one-third of prior authorizations for outpatient services by next year, the latest insurer to address the tedious paperwork process that has been a pain point for patients and providers.
The company will remove the authorization requirement for diagnostic services across colonoscopies and transthoracic echocardiograms and select CT scans and MRIs by January 1, 2026."
@OP It means that there will be 1/3 less work if you work in a role that does prior authorizations because they are eliminating the requirement for a review for necessity. The news said focus is on eliminating diagnostic screening reviews.
What exactly does that mean? I’m sorry I work in a different department.