Insurance companies putting up too many barriers
Insurance companies are erecting too many burdensome barriers. Case in point: last month, UnitedHealthcare (UHC) rolled out a confusing Advance Notification program requiring gastroenterologists to collect and input vast amounts of patient data before performing endoscopies and colonoscopies. These time-sensitive GI procedures are vital for detecting and treating various diseases, from colorectal cancer to inflammatory bowel disease.
If UHC can be taken at face value, no patient will be denied care or face disruptions by this new process, but how can we trust a company that has lacked transparency and failed to coordinate with physicians? This poorly defined Advance Notification program was haphazardly rolled out after UHC received backlash from the gastroenterology community on its original plans to require prior authorization, a process through which insurers give the final say over whether a patient can receive treatment determined necessary by their doctor.
This policy change will negatively impact gastroenterology practices. The arduous data entry before every patient case is a tremendous strain on staff, time, and resources. The future impact is on our patients. Data collected through Advance Notification will inform UHC's ambiguous "Gold Card" program, a prior authorization program set to launch in 2024 for its 27 million commercial beneficiaries. According to UHC, data collected now will help determine if there is overutilization of these vital services and by whom. Ironically, this admission confirms the suspicion among the gastroenterology community that UHC has never had data to justify prior authorization.
Our patients are real people; they pay monthly premiums to cover the cost of their medical care and they deserve timely access to the colonoscopies and endoscopies that can be lifesaving. UHC should immediately remove these barriers and work with the gastroenterology community to identify real solutions to improve, not undermine, patient access to care.
Joseph Losurdo
Elgin