Chris Pokabla, MD, “We Need You: Tell Your Prior Authorization Story”

So many of us have lived with the onerous process of prior authorization throughout our careers. In my own practice, it is routine to call the insurance company, have a member of my staff sit on hold for up to 45 minutes, only for me to end up on the phone with a colleague who is not board-certified in orthopedics determining the fate of my clinical judgment.  

Let’s assume for a moment that the decision to implement this process years ago was one made in good faith to save costs within a financially inflated healthcare system. Even then, I know none of you or your staff have time to sit on hold all day while patients wait (and in many cases, suffer) for the approvals to come through. I know of one larger practice in our community that has 5-6 FTE’s exclusively dedicated to handling prior authorization requests. And in some extreme cases, there are reports of patients passing away while awaiting approvals for procedures that could’ve saved their life. How is this good for the healthcare system? How does this save money? 

In most cases for me, and I’m told by many others, the case goes on to be approved anyway. And when they’re denied, we often appeal, which delays the process even more. 

I applaud the TMA for deciding to take on this important issue in medicine. This effort represents what we should be doing to support healthy physicians who run healthy practices with the healthiest patients possible.  

And now, we need you and your practice to act. We need you to click the QR code below and tell your prior authorization story. 

It is a short form and easy to fill out. You can be as brief or descriptive as you want in your narrative. You can also have TMA staff reach out to you for more detailed information. I encourage you to check that box.  

If we don’t flood the legislature with these all-too-real stories, then they will assume that we are simply crying wolf.

Going back to health physicians, don’t forget we offer Thrive, our physician wellbeing program who has a wellness hotline as its flagship offering. The hotline connects you to a psychologist CONFIDENTIALLY and our 501c3 partner Memphis Medical Foundation covers your costs. The program is 100% funded by private physicians. 

Be on the lookout for our fall events, a member happy hour and our annual legislative rejection. I hope to see you there.