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news
September 25, 2024
A precarious waiting game: Prior authorization and patient care
By DR. EDGAR ?BUD? BOYD PRESIDENT OF THE OKLAHOMA STATE MEDICAL ASSOCIATION

“Prior authorization.” Largely unknown until a few years ago, it’s quickly become one of those insurance terms that’s sure to give any medical provider or patient an instant headache.

Insurance companies require prior authorization for certain procedures, tests and medications. In order to approve treatment, the insurance company puts a hold on a claim while it is reviewed on its end before an approval or a denial is issued. This process was implemented to keep costs down and limit egregious claim approvals, all to the benefit of the insurance company.

As our system stands, insurance companies are a necessary part of our health care model, but at the end of the day, they’re for-profit entities. Their cost-saving measures tend to outweigh what’s best for patients, and that’s when problems arise. Unfortunately, it’s happening all too often.

As a physician, I can attest that prior authorization has been a pain point for me—and, more importantly, for my patients—for many years. Which treatments require prior authorization isn’t always clearly spelled out, leaving physicians and patients to navigate a minefield of authorization-related delays and denials. Physicians and staff routinely spend hours on administrative tasks related to prior authorization, like submitting documents and following up on approvals, spending precious patient time listening to the insurance companies’ hold music. It’s frustrating and can be dangerous as delays for patients with time-sensitive treatment plans can be life threatening.

Now, AI has crept into the prior authorization process. Patients have long been denied access to medical care as a result of prior authorization reviews, but these days, a computer may be issuing the denial. There’s not even a human involved in the process, much less a doctor. This is unacceptable.

The tide is turning, but there’s still much work to be done: Prior authorization has been recognized as an issue by lawmakers, and in May of this year, the Ensuring Transparency in Prior Authorization Act was signed into law. When it goes into effect in 2025, the law will establish more stringent and transparent timeframes and policies for prior authorizations. Insurance companies will be required to modernize their authorization systems, publish prior authorization requirements online and require licensed medical professionals to make denials, just to name a few.

This is a win for all Oklahomans. It ensures patients receive timely, appropriate treatment, as determined by medical professionals. Plus, it allows physicians— many of whom are already stretched thin, especially in rural areas—to spend more time treating patients and less time on administrative runaround.

At the end of the day, our patients trust medical professionals with their lives, not insurance companies. Red tape has no place in health care.

Edgar Morris Boyd, M.D. is an otolaryngologist in Muskogee, where he practices at the Warren Clinic Saint Francis Health System. He is president of the Oklahoma State Medical Association.

Highway 150 memorial sign unveiled for fallen heroes
A: Main, news
Highway 150 memorial sign unveiled for fallen heroes
By LaDonna Rhodes Staff Writer 
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On Friday, March 27, friends and family of the late William “Bill” Walker, an OHP State Trooper, and the late T. Leo Newton, Fountainhead Park Superintendent, gathered together to participate in the u...
Chili supper brings community together for EFUMC building fund
A: Main, news
Chili supper brings community together for EFUMC building fund
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Eufaula residents turned out Friday evening for a night of food, fellowship and giving as the EFUMC United Methodist Men hosted their “Chili for the 180” Building Fund Dinner at the church. Held March...
A: Main, news
Teen drowns on Lake Eufaula
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A 17-year-old drowned on March 20, on Lake Eufaula approximately two miles north east of Canadian in Pittsburg County. According to reports, the Oklahoma Highway Patrol (OHP) and several other local a...
A: Main, news
Easter fun set to hop across McIntosh County
April 1, 2026
McIntosh County is gearing up for an egg-citing Easter weekend, with events planned that promise everything from traditional hunts to eggs falling straight from the sky. Kicking things off, Lake Eufau...
Setting their sights to the future
A: Main, news
Setting their sights to the future
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The Eufaula Board of Education voted in a special meeting Thursday morning, March 26, to hire Brian Hummingbird to succeed current superintendent Monty Guthrie, who is retiring this summer. Currently ...
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City of Eufaula partners with chamber to support community events in 2026
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The City of Eufaula is partnering with the Eufaula Chamber of Commerce as a sponsor of community events in 2026, supporting efforts to bring more activity and energy to the community. The partnership ...
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Reminder: Election Day is Tuesday, April 7
A: Main, news
Reminder: Election Day is Tuesday, April 7
April 1, 2026
Eufaula voters will head to the polls to decide the school board race for District 1 between Martha Asher (incumbent) and Amber Baughman. Polls are open from 7 a.m. to 7 p.m. on Tuesday, April 7. Curr...
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Eufaula Indian Community Center to host Indian Arts & Crafts Gathering – April 4
April 1, 2026
The Eufaula Indian Community Center invites you to an Indian Arts & Crafts Gathering on Saturday, April 4, from 10 a.m. to 3 p.m. at 800 Birkes Road in Eufaula. This gathering will feature handmade wo...
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Eufaula leaders attend conferences on tribal justice and collaboration
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City of Eufaula leadership recently participated in a series of conferences focused on tribal jurisdiction, law enforcement coordination, and strengthening partnerships between municipalities and Trib...
Kirstin Clark Pages at Capitol
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Kirstin Clark Pages at Capitol
By REP. TIM TURNER 
April 1, 2026
Kirstin Clark, a junior at Canadian High School, paged in my Capitol office this past week. Kirstin is the daughter of Amber Clark. She’s vice president of Student Council, a reporter for FFA, and she...
Behold the Lamb
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Behold the Lamb
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In a world full of wolves in sheep’s clothing can you still recognize the Lamb? “Behold, the Lamb of God, who takes away the sin of the world!” (John 1:29) John the Baptist spoke these words to identi...
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