Utilization Management “New Normal” Means Challenges with Prior Authorizations and Appeals

Spine surgery faces utilization management challenges that are influencing patients’ access to care and surgeons’ abilities to navigate the current payor environment. Device companies can better serve surgeons and their patients by remaining abreast of changes to the payor climate.

Prior Authorization Chaos is the New Normal for Spine Surgery

A 2017 physician survey revealed that 86% of offices' prior authorization activities had increased significantly over the last five years, with the average office spending two full workdays to receive a prior authorization. Kim Norton, Vice President of Reimbursement at Simplify Medical, lends insights on how this trend affects the spine market.