logo
Login Subscribe
Google Play App Store
  • News
    • Obituaries
    • Lifestyle
    • Opinions
  • Sports
  • E-edition
  • Public Notices
  • Calendar
  • Archives
  • Contact
    • Contact Us
    • Advertisers
    • Form Submission
    • About Us
    • News
      • Obituaries
      • Lifestyle
      • Opinions
    • Sports
    • E-edition
    • Public Notices
    • Calendar
    • Archives
    • Contact
      • Contact Us
      • Advertisers
      • Form Submission
      • About Us
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.

Muscogee Nation celebration marks opening of Lake Eufaula Casino Hotel
A: Main, news
Muscogee Nation celebration marks opening of Lake Eufaula Casino Hotel
December 17, 2025
SHAUNA BELYEU GENERAL MANAGER Leaders from the Muscogee Nation and the Muscogee Nation Gaming Enterprises (MNGE) held a ceremonial ribbon-cutting on Monday, Dec. 15, to open the doors on a $69.8 milli...
Sweet Success at the Eufaula Chamber Cookie Crawl
A: Main, news
Sweet Success at the Eufaula Chamber Cookie Crawl
By Shauna Belyeu General Manager 
December 17, 2025
Downtown Eufaula was filled with holiday cheer and the irresistible aroma of fresh-baked treats as the Eufaula Area Chamber of Commerce hosted its annual Cookie Crawl on Saturday, Nov. 13. The event, ...
Main Street project update
A: Main, news
Main Street project update
December 17, 2025
The Oklahoma Department of Transportation (ODOT) has shared a revised timeline for the Main Street Improvement Project. The new estimated completion date is now the first week of January 2026. We know...
Shop with a Cop brightens Christmas
A: Main, news
Shop with a Cop brightens Christmas
December 17, 2025
Dozens of McIntosh County kids were escorted on a Christmas shopping spree by law enforcement officers last week. In total, over 80 kids received a total of $30,000 worth of presents. Each purchased g...
Is your name on the list?
A: Main, news
Is your name on the list?
By Shauna Belyeu General Manager 
December 17, 2025
The Oklahoma State Treasurer’s Office has released its latest report of unclaimed property, and the full list of names appears inside this week’s edition on page 3. Every year, millions of dollars in ...
Elves of Texanna Toy Giveaway brings Christmas joy to local children
Community Calendar, lifestyle, news
Elves of Texanna Toy Giveaway brings Christmas joy to local children
December 17, 2025
The Elves of Texanna Toy Giveaway returned this past Sunday, Dec. 14, continuing a holiday tradition that has helped make Christmas brighter for local children and families. The event, organized by La...
ePaper
google_play
app_store
Editor Picks
Haltom’s Huddle Food Drive brings holiday cheer to local families
lifestyle, news
Haltom’s Huddle Food Drive brings holiday cheer to local families
December 17, 2025
Over the past month, residents and readers came together in a powerful show of community spirit for the annual Haltom’s Huddle Food Drive. Thanks to their generosity, hundreds of non-perishable food i...
Past school records to be destroyed
Community Calendar, news
Past school records to be destroyed
December 17, 2025
Checotah High School will be destroying past graduate records. If you graduated in the school year 2020, you can pick up your high school records. You may call ahead at (918) 473-9100 to arrange picku...
Roger Thompson to keynote Friends’ event
Community Calendar, lifestyle, news
Roger Thompson to keynote Friends’ event
December 17, 2025
“How Christmas Started and Surged” will be the topic explored at the 1 p.m. Friday, December 19 meeting of Friends of Eufaula Memorial library. How can Odin, the Norse God of wisdom, poetry, agricultu...
SOAR gives back to God’s Helping Hands
news
SOAR gives back to God’s Helping Hands
December 17, 2025
The Southeastern Oklahoma Board of REALTORS has always believed in the importance of giving back to the communities they serve. This commitment was once again demonstrated at the annual Christmas Part...
Lake Eufaula family loses dream home in fire
news
Lake Eufaula family loses dream home in fire
December 17, 2025
Craig and Chelsea Lewis experienced their worst nightmare when their dream home on Lake Eufaula was reduced to charred rubble just weeks before Christmas. “Overnight, it ended up being a total loss,” ...
Facebook

THE EUFAULA INDIAN JOURNAL
100 N. 2nd Street
Eufaula, OK 74432

(918) 689-2191

This site complies with ADA requirements

© 2023 THE EUFAULA INDIAN JOURNAL

  • Contact
  • Privacy
  • Accessibility Policy