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Delays & Preauthorization Coverage Denials can Impact Practices

By Admin | May 10, 2016

"Further, respondents indicated surgery preauthorization does not lead to appropriate reimbursement in approximately one-third of the cases,” states a study conducted by the International Society for the Advancement of Spine Surgery.

This is but one of the many sobering conclusions pulled from the survey sent to 571 spine surgeons in the U.S. The 14-question poll asked surgeons about third party payment habits, specifically denials and delays and how those can have an impact on spine practices.

Other findings include that approximately 24 percent of cases yielded reduced payments even though they were preauthorized. And then 9.4 percent of preauthorized cases weren’t paid at all.

58.5 percent of denials took place within three days of scheduled surgeries.

To read more about this survey, visit Becker’s Spine Review and read “Spine surgery coverage denials cost surgeons $191k: 5 key notes” by Laura Dyrda, posted on April 27 2016.

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