Small Group Workshops


Navigating the Prior Authorization Process

Friday, October 11, 2019
4:10 pm – 5:00 pm


Kim K. Birtcher, PharmD

Prior authorization (PA) requires healthcare providers to seek approval from a payer before certain medications or procedures will be covered: a time-consuming and costly process for clinicians, which can impact treatment strategies and patient care. In conducted national surveys, 84% of physicians claim that the burden associated with PAs is very high: physicians and staff spend approximately 15 hours each week completing the workload associated with PAs. Furthermore, a staggering 79% claim that they are often required to repeat PAs for prescription medications, even when a patient is stabilized on a treatment regimen for a chronic condition. Not surprisingly, the PA burden is most frequently passed to the patient, with 92% of patients reporting care delays if their respective treatments require PAs. Through practical case-based presentations, this workshop will provide participants with recommendations and resources for streamlining the PA process in their practices: with the ultimate goal of reducing the associated burden on healthcare providers, minimizing related stress for patients, and preserving time for direct patient care.

Learning Objectives:

  • Describe the burden of the prior authorization process on physicians and staff in clinical practice and patient outcomes
  • Review strategies and resources that can reduce the time and expenses associated with submissions for prior authorization
  • Identify prior authorization processes to gain drug & procedure approval for patients in a timely manner