Blue Cross Blue Shield of Alabama says it is reforming the process for getting prior authorization for insurance coverage of certain medical procedures and drugs – promising a simpler, more efficient system for patients and doctors. <\/p>\n
The move in Alabama comes as insurance companies nationwide are making similar changes to their approval process, impacting a total of 257 million Americans. <\/p>\n
\u201cThe health care system remains fragmented and burdened by outdated manual processes, resulting in frustration for patients and providers alike. Health plans are making voluntary commitments to deliver a more seamless patient experience and enable providers to focus on patient care, while also helping to modernize the system,\u201d said Mike Tuffin, president and CEO of America\u2019s Health Insurance Plans, the national trade association representing the health insurance industry. <\/p>\n
READ MORE: Alabama auto plant exports only 14 vehicles in June as Trump\u2019s 25% tariff hits industry<\/b><\/a><\/p>\n What is prior authorization?<\/p>\n Prior authorization is the process where healthcare providers must first get approval from a patient\u2019s health insurance plan before providing certain treatments or medications. <\/p>\n Blue Cross Blue Shield of Alabama told AL.com<\/a> they will implement a series of improvements to their prior authorization process, including: <\/p>\n \u201cImproving the prior authorization process will help us create an efficient, affordable, and sustainable health care system for Alabama,\u201d Sophie Martin, a spokesperson for Blue Cross Blue Shield of Alabama said in an email. \u201cWorking together \u2013 with our provider partners and across health insurers – will ensure patients receive the most effective care, at a more affordable cost.\u201d <\/p>\n The health insurance provider is the largest in the state, with 86% of the market share, according to the American Medical Association<\/a>. <\/p>\n Blue Cross Blue Shield entities across the country have also signed on to the prior authorization reforms, along with providers like UnitedHealth, Humana and Cigna. <\/p>\n \u201cThese measurable commitments \u2013 addressing improvements like timeliness, scope and streamlining \u2013 mark a meaningful step forward in our work together to create a better system of health,\u201d said Kim Keck, President and CEO of the Blue Cross Blue Shield Association. \u201cThis is an important foundation to address bigger problems together, at a time when technology and interoperability can deliver real improvements to patient experience.\u201d<\/p>\n\n