Jan 15th 2019

Top 10 Blog Posts of 2018

Happy New Year! As we move into 2019, we wanted to take a moment to review some of the knowledge that we shared over the past year. We addressed some of the complexities of the prior authorization process; defining what it is, and why it exists, to discussing some of the improvements that need to be made. We also shared some tips and insights on how to more effectively navigate the current prior authorization process. 

In case you missed any of these helpful resources, here are our top 10 most popular posts from 2018. 

1. AMA Survey Shows Need for eviCore's Prior Authorization Improvements
As a family-practice physician of more than 30 years, I know the frustrations prior authorization can cause. Almost everyone involved in healthcare can agree there are plenty of opportunities for improvement, and a recent physician survey by the American Medical Association (AMA) shows why. About 84 percent of physicians surveyed said they believe the burdens associated with prior authorization are high or extremely high, and a similar number (86 percent) believe those burdens have increased during the past 5 years. 

2. Recognizing the Caregiver in the Room
Behind nearly every patient is a family caregiver. Today, an estimated 43.5 million Americans provide unpaid care to an adult or child—from bill paying and grocery shopping, to managing and administering complex medication. 

3. The Eight Most Common Inappropriately Ordered Tests — and Why They're Being Denied
We've compiled a list of the eight most common inappropriately ordered tests (from least common to most common), with explanations on when they're appropriate, and when they may be denied because they're not the best treatment option. 

4. Saving the Cost of Care from "Incidentalomas"
When seeking care for your health, hearing the word "no" can be a frustrating and frankly scary experience. For those of you reading this and thinking, this sounds exactly like what I'm concerned about right now, we ask you to join us for a few moments as we explore what a world without prior authorization for these tests might look like. 

5. Ask eviCore: Physical Therapy
Welcome to our new series, Ask eviCore, where we answer some of the questions submitted by providers and their office staff.  I'm Mark Tate, the leader of eviCore's Provider Experience group. This month, after receiving several emails about Physical Therapy (a topic dear to my heart, as I served 6 years as a licensed Physical Therapist), we address the number of units and visits eviCore approves based on a prior authorization request.  We appreciate all of your thoughtful questions, so keep them coming! 

6. Tip #3: "How Can I Avoid Peer-to-Peer Phone Calls?"
In our  first two blog posts on how to avoid peer-to-peer (P2P) phone conversations, we shared some tips on how to make the process of obtaining prior authorization easier and more efficient for clinicians and administrators. The best way to avoid denials, appeals, and P2P phone conversations is to obtain prior authorization "right out of the gate" when your office's prior authorization employee (PAE) makes the initial request for an approval number. 

7. Provider Playbook Series: MRI of the Lumbar Spine without Contrast
Like you, eviCore wants to make sure your patients get the right test, treatment, or procedure for their needs―while preventing inappropriate care and its potential dangers and unnecessary costs. That's why we're creating our Provider Playbook series of topical one-pagers designed to help you deliver the best care for your patients. This series will focus on some of the most common inappropriately ordered tests and treatments and provide information from the current evidence-based medical literature to support the delivery of the right care every time. 

8. [INFOGRAPHIC] How to Avoid Peer-to-Peer Phone Calls
As a doctor, your work day is full of challenges. The truth is, we know the oldway of managing prior authorization can be cumbersome and inefficient. So that's why we are changing things. Read and download the infographic to learn tips on how to make the process of obtaining prior authorization easier and more efficient for clinicians and administrators. 

9. How to Make Prior Authorization Painless for Patients
The wordy, confusing letters that patients sometimes receive telling them that their doctor's request for a procedure or lab test has been denied can be frustrating—particularly if the patient isn't familiar with prior authorization or doesn't know that it's a requirement for most health plans. Because these lengthy letters tend to be scripted according to health and regulatory requirements, we offer the following tips on how providers can help their patients avoid them altogether. 

10. Safety First: Help Patients Understand Prior Authorization
There's an old expression that, "It's better to ask for forgiveness than permission." But in today's healthcare world, the opposite is true—it's always better to ask for permission. The need for prior authorization for various treatments is a fact of life for almost everyone in healthcare. But while clinicians understand that, patients often don't. 

Bonus Post: The field of medicine has exploded. We help providers meet some of the challenges by being a resource to assure that the patient gets the best care. In case you missed it, make sure to watch our empowering the improvement of care video below.