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.

Reindeer lands in Kiwanis Park
news
Reindeer lands in Kiwanis Park
By Shauna Belyeu General Manager 
December 24, 2025
Families gathered at Kiwanis Park on Thursday, Dec. 18, to celebrate the holiday season with festive cheer and a cup of Christmas cheer. The Eufaula Chamber of Commerce hosted its annual Hot Chocolate...
The newest dog at the Eufaula pound is a real sweetheart and all he wants for Christmas is a fur-ever home with YOU
news
The newest dog at the Eufaula pound is a real sweetheart and all he wants for Christmas is a fur-ever home with YOU
December 24, 2025
The newest dog at the Eufaula pound is a real sweetheart and all he wants for Christmas is a fur-ever home with YOU. Paws N Claws is also looking for sponsors for his $85 adoption fee and spay/neuter ...
God’s Helping Hands provides Christmas meals for hundreds
news
God’s Helping Hands provides Christmas meals for hundreds
December 24, 2025
For 25 years, God’s Helping Hands has been feeding hundreds of needy families during the Christmas season. “God’s Helping hands began 26 years ago,” said Director Richard Mc-Cool. “But we didn’t do it...
Eufaula decks the hall for inaugural holiday home tour
news
Eufaula decks the hall for inaugural holiday home tour
By Shauna Belyeu General Manager 
December 24, 2025
The Lake Eufaula Association (LEA) celebrated a successful launch of its first-ever Christmas Home Tour on Thursday, Dec. 11, drawing close to a reported 100 participants for a festive afternoon explo...
Christmases past and present
commentary
Christmases past and present
December 24, 2025
Christmas always brings a flood of emotions every year as I try to navigate all the changes of my Christmases past to my Christmas present. For so many years I had my whole family beside me each Chris...
May your season be bright and joyous
commentary
May your season be bright and joyous
By JOE DORMAN OICA CEO 
December 24, 2025
OKLAHOMA CITY – I hope each of you is looking forward to the upcoming Christmas break and will have time to spend with loved ones. As a Christian, Christmas is one of my favorite holidays and is a ver...
ePaper
google_play
app_store
Editor Picks
Legislative Year One wrapping up
commentary
Legislative Year One wrapping up
By REP. TIM TURNER 
December 24, 2025
It’s the end of my first year in office representing District 15. It’s been very interesting to say the least. I wouldn’t trade this time for anything. In addition to helping with numerous constituent...
Dan Kirby conviction of involuntary manslaughter charge overturned
news
Dan Kirby conviction of involuntary manslaughter charge overturned
By JERRY FINK MANAGING EDITOR 
December 24, 2025
In March 2023, former Eufaula City Councilman Dan Kirby was indicted in federal court for involuntary manslaughter in Indian Country in connection with a motorcycle accident on July 23, 2022 that clai...
news
Navigating power and technology breakdowns
By GLEN MULREADY OKLAHOMA INSURANCE COMMISSIONER 
December 24, 2025
In December 2007, Oklahoma experienced one of the most devastating ice storms in its history. The storm caused at least $200 million in damage statewide, and at the peak of the event, more than 641,00...
commentary
Bah Humbug to shame: Change the labels that haunt Christmas
December 24, 2025
Christmas week has arrived, and for many, it’s not always merry. While the season shines with joy and light, it can also stir painful memories— old regrets, lingering shame, and labels we wish we coul...
commentary
God’s divine interruption
By REV. THERESE STARR 
December 24, 2025
I have a little refrigerator magnet that says, “We plan; God laughs.” It’s a constant (and much needed) reminder that my own plans for my day, my week or even my life are not the final word as far as ...
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