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Shifting rules and overall payer complexity make it difficult for health systems to stay ahead of what they need to get prior authorization requests approved, which lengthens the time an auth takes and results in more denials.
Why is it so hard to get a prior authorization?
43% of patients went through prior authorization the first time a medication was prescribed. 37% of patients go through prior authorization every plan year. Three days was the average wait time for prior authorization approval, but 31% of respondents said they had waited more than a week.
Why do prior authorizations get denied?
The most common reason in my experience why PA requests get denied, is quite simply a lack of information. For example, its very common for PA requests for MRIs or CTs to require that an X-ray and/or ultrasound be done first, to see if that will provide enough information for the doctor to treat the issue.
Is Coventry under Aetna?
Coventry Health Care, Inc. In May 2013, the company was acquired by Aetna for $5.7 billion.
How many days does a prior authorization take?
How long does the prior authorization process take? It typically takes 24 to 72 hours. You may check the status of your prior authorization request on the prior authorizations page. You may also contact your doctors office directly.
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