Reply To: PET/CT scans

[Mandi Murph]

Our institution has transitioned to utilizing a radiology authorization team. This is a team of non clinicians interpreting and providing clinical information can sometimes trigger a delay in a review or result in a peer to peer. Overall the team is pretty good and this service has been helpful to alleviate some work load from our secretaries. The only pitfall is when they have multiple auths to that require peer to peer and we as the clinicians are only provided with a short window of time to obtain this.

Most of the pvt payor companies we deal with have transitioned to a scheduled peer to peer appointment call. The negatives are that at times when an urgent auth is needed and no MD is available this can delay care rendered to the pt.
Positives: you can (most of the time) choose the time when you would like to conduct the call, you can plan and prepare for it rather than having a reactive call with a scheduler/ secty calling asking you to get on the phone with the doctor who is on the line at that moment. I find the docotor is prepared for the call and that has contributed to a quicker and more often pleasant call.
At times when I really need an auth before the next day, I have been successful with speaking to an MD within a short time frame or scheduled for later in the day/ just after clinic hours.

Indeed though this is just one example of the numerous areas of a patients care that requires review and authorization.