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.

In Part I of this overview, I discussed prior authorization in general. In this second article, I will further delineate what surgeons are experiencing with two specific, important...

document icon

You are out of free articles for this month

Subscribe as a Guest for $0 and unlock a total of 5 articles per month.

You are out of five articles for this month

Subscribe as an Executive Member for access to unlimited articles, THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT and more.


Kim Norton is Vice President of Reimbursement, Simplify Medical and Reimbursement Consultant, has worked in medical device reimbursement, payor relations and market access for over 25 years. Her career spans venture-backed start-up companies, mid-sized and large device companies, and roles in consulting. Ms. Norton has worked across the spectrum of health plans, from CMS to commercial plans to Workers Compensation and has primarily focused on implantable Class III devices.

Contact Us