Delayed Patient Care Due to Administrative Policies

By Ashton J. Hyde on March 05, 2019


A stethoscope and judge's gavelReceiving proper medical care in a timely manner can literally mean the difference between life and death. That’s why the Salt Lake City, UT medical malpractice lawyers of Younker Hyde Macfarlane take these mattes seriously. Whether the delay in treatment is caused by doctor, surgeon, clinic, or hospital errors, our team of attorneys is here to help.

Our law firm can also assist patients and their loved ones with administrative issues that lead to delays in treatment. Prior authorization is the most well known policy that results in treatment delays. Let’s cover the basics of prior authorization and why it places a major burden on physicians as well as patients.

About Prior Authorization

Prior authorization is a requirement that your physician gets approval from your health insurance provider for any medications prescribed or treatment performed. The treatment an go forward so long as it has been pre-approved by the insurance company.

The Dangers of Prior Authorization

This sounds straightforward, but prior authorization takes more time than you may think. Waiting for medication or medical procedures due to these administrative matters could have a negative impact on your health.

Statistics on Prior Authorization and Delayed Care

According to a survey of 1,000 physicians by the American Medical Association (AMA), 92 percent said that prior authorization programs have a negative overall impact on patient care and wellness. The survey also noted that 84 of prior authorization issues result in high or very high burdens on health care providers and their patients. What’s more, 86 percent of physicians felt that these prior authorization burdens have gotten worse in the last five years.

The AMA survey also revealed that prior authorization delays could alter the recommended course of treatment for a patient. 78 percent of survey respondents said that prior authorization caused some patients to abandon the recommended treatment altogether.

How Long Are Prior Authorization Delays?

According to the previously cited AMA survey, 64 percent of physicians say that a prior authorization delay takes about one business day; 30 percent of physicians reported waiting three business days or longer.

The AMA surgery goes on to explore the individual timeframes physicians face dealing with the numerous administrative issues. During the course of a week, an average physician will have to address 29.1 prior authorization requirements, which will take about 14.6 hours to process. The AMA survey noted that 34 percent of physicians rely on staff members to process these prior authorizations. These staffers are focused solely on data entry and other matters related to prior authorization.

Who Should Be Held Liable for Delayed Treatment?

While prior authorization is an administrative reality, patients should not have to suffer because of bureaucracy. Even a single business day can make the difference between good health and a deterioration in a patient’s condition.

So who should be held accountable? It depends.

If you or a loved one has experienced delayed medical care because of administrative issues like prior authorization, our medical malpractice lawyers can help. We will go over the details of your case and determine who should be held liable for delayed treatment. We can then offer legal counsel.

Contact an Experienced Medical Malpractice Lawyer

To learn more about your legal rights and options, be sure to contact our team of medical malpractice and administrative error lawyers. The attorneys of Younker Hyde Macfarlane are here to help. You can reach our legal team by phone at (801) 335-7025.

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