HealthDay (3/25, Pallarito) reported that research suggests kids “with severe psychiatric problems often have lengthy waits before they’re transferred from a hospital emergency department to a psychiatric hospital due to insurance companies’ ‘prior authorization’ requirements.” Investigators looked at data on more than 200 patients. The researchers found that “mental health workers at one Rhode Island hospital spent an average of an hour on the telephone seeking insurance companies’ approval.” However, insurers eventually approved all of the admissions, which “suggests that prior authorization appears to serve ‘more as an administrative hurdle,’ the study authors wrote.”
The findings were published in the American Journal of Emergency Medicine. Dr. Joseph Mawhinney, a member of the American Psychiatric Association’s Council on Healthcare Systems and Financing, and chair of the APA’s Access to Care Workgroup, “called the prior authorization process ‘a bureaucratic maze’ wrought with wrong phone numbers, dropped calls and people at the other end of the line not having authority to make a decision, requiring a referral to someone else.”
Related Links:
— “Troubled Kids’ Psychiatric Care Often Delayed by Insurance Rules,” Karen Pallarito, HealthDay, March 25, 2016.