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Medical Professionals Want Changes To Insurance Pre-Approval Process For Healthcare

Healthcare professionals across the state, including some who work for OSF, which runs Peoria’s Saint Francis Medical Center, are hoping to change how insurance goes about approving requests for medical treatment.

Lawmakers want to change how people get insurance company approval before medical treatment. Advocates say the current process harms patients.

It’s a reintroduced bill after the previous one stalled during the pandemic slowdown in legislative work.

The bureaucratic term is “prior authorization.” Doctors have to clear certain prescriptions and procedures with insurance companies before they go ahead and help patients.

The bill would force insurers to put information on their websites about prior authorization requirements and restrictions for specific procedures. It also limits how long providers can take to approve or deny a request. A doctor who has knowledge of the issue at stake would also have to review appeals.

Dr. Robert Panton is the president of the Illinois State Medical Society. Panton said similar reforms have already been adopted in four other states: Arkansas, Delaware, Kentucky, and Ohio.He said prior authorization isn’t a bad idea, or at least it didn’t start out that way.“The entire concept of prior authorization started as a reasonable concept to help direct care, and to […]

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