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.

Rae of Sunshine hosts Autism Awareness Festival in Eufaula
A: Main, news
Rae of Sunshine hosts Autism Awareness Festival in Eufaula
By Shauna Belyeu General Manager 
April 22, 2026
Rae of Sunshine brought families together for a day of connection, activity and awareness during its first Autism Awareness Festival in Eufaula. The event, organized by owner Desirae Parish, for whom ...
A: Main, news
Suspect accused of striking patrol car, fleeing deputies before arrest
By Shauna Belyeu General Manager 
April 22, 2026
A McIntosh County man was arrested April 16 on a complaint of assault and battery with a dangerous weapon, according to a probable cause affidavit. Steven Wayne Smith, 54, of Checotah, was taken into ...
Monty Guthrie named District 10 Superintendent of the Year
A: Main, news
Monty Guthrie named District 10 Superintendent of the Year
April 22, 2026
The Oklahoma Association of School Administrators (OASA) is pleased to announce Monty Guthrie of Eufaula Public Schools as the 2026 OASA District 10 Superintendent of the Year. Guthrie will be recogni...
Checotah daycare case moves forward in district court
A: Main, news
Checotah daycare case moves forward in district court
By Shauna Belyeu General Manager 
April 22, 2026
A Checotah couple accused of abusing children in an in-home daycare appeared April 16 in McIntosh County District Court for a preliminary hearing before Associate District Judge Brendon Bridges. Jacob...
A: Main, news
Election Board hears contest in county commissioners race
By Shauna Belyeu General Manager 
April 22, 2026
The McIntosh County Election Board heard testimony at 10 a.m.Thursday, April 16, in a contest of candidacy filed against District 1 County Commissioner candidate Jeffery Coleman (McIntosh County sheri...
Chamber honors local businesses, leaders at annual banquet
A: Main, news
Chamber honors local businesses, leaders at annual banquet
April 22, 2026
The Eufaula Area Chamber of Commerce celebrated a night of food, fellowship and recognition on Thursday, April 16, during its annual banquet at Dobber’s, bringing together community members, business ...
ePaper
google_play
app_store
Editor Picks
Eufaula High School Drama Club forges new tradition with inaugural Hansard Awards
news
Eufaula High School Drama Club forges new tradition with inaugural Hansard Awards
April 22, 2026
This spring, Eufaula High School is bridging the gap between the gridiron and the stage. The EHS Drama Club is proud to announce the debut of the Hansard Awards, a new tradition honoring the enduring ...
Autism Awareness Festival fun
news
Autism Awareness Festival fun
April 22, 2026
and sweets from High Class Goods. For Laura Park, who is new to the area, the event left a lasting impression. “It was such a great event,” Park said. “It really meant a lot to see something like this...
Marketing is a conversation, not a megaphone
news
Marketing is a conversation, not a megaphone
By ALICE CANADA 
April 22, 2026
Welcome back to Marketing on Main Street. If you are joining us for the first time, you can catch up on previous columns on the Cookson Hills Publishers blog at Cookson. News. In this series, we focus...
news
Texanna Lady Crafters
April 22, 2026
Cookies, cakes and pies…oh my! Hot dogs and yard sale, a shopper’s delight. The TLC event is just around the corner. May 1 and 2 from 10 a.m.- 3:30 p.m.. Items for yard sale are too numerous to list a...
1968 and now: When space united a divided nation
commentary
1968 and now: When space united a divided nation
April 22, 2026
Stop me if you’ve heard this one. In the months after a very contentious election, our nation seems more divided than at any time since the decade before the Civil War. The new Republican president is...
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