Credentialing and Insurance Reforms

Home > Advocate > Topics > Credentialing and Insurance Reforms and Insurance Reforms<p><img src="/PublishingImages/CredentialingInsuranceReforms.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;" />News on the latest efforts to voice physician concerns about insurance practices that take time away from patient care. One example is legislation that would streamline physician credentialing.</p><p>PAMED also supports legislation that would overhaul the prior authorization process, require fair payer contracts, and limit payer retroactive payment denials to 180 days.</p> Auth Delays Prolong Teenagers’ Arthritis Pain<p>​Middletown, Pa., teenager Zachary Souders went from doctor to doctor for two years before learning the source of his chronic lower back pain: Juvenile idiopathic arthritis.</p>Legislators;# Prior Auth Delays Eastern PA Man From Weaning Off Opioids<p>Physicians say the use of prior auth has grown out of control. Few stories illustrate it better than that of Joe Stanziano, who experienced prior auth delays the prevented him from weaning off pain meds.</p>Physicians;#Legislators;# Man On Insurance Delay: ‘What If I Would Have Died With This?’<p>Pittsburgh resident Jeff Duncan was convinced he had a sleep disorder when his mother noticed he momentarily stopped breathing while taking a nap in late 2016.</p>Physicians;#Legislators;# Auth Delay Allowed Pittsburgh Woman’s Undiagnosed MS to Progress<p>Kristen O'Toole lived a healthy, active life as communications consultant in Pittsburgh. That changed suddenly and dramatically in 2014 when she experienced back pain.</p>Physicians;#Legislators;# Auth Insurance Delays Hurt Patients; Legislation Aims to Improve Process <p>Improving transparency, standardization, and response times of prior authorization in Pennsylvania is the goal of HB 1293, a bill recently introduced by State Rep. Marguerite Quinn (R-Bucks). </p>Physicians;#Legislators;# Meets with Stakeholders to Discuss Out-of-Network Billing Legislation <p>​On Aug. 29, 2017, PAMED attended a meeting with stakeholders to discuss HB 1553, one of the “surprise” billing pieces of proposed legislation that PAMED has been following.<br></p> to Reform Insurer Credentialing Process Passes Pa. House in Unanimous Vote<p>​A bill which seeks to reform the process of insurer credentialing for health care practitioners was passed unanimously by the Pa. House on May 24, 2017. The bill now moves on to the Pa. Senate for consideration.</p> Physicians Share How Highmark Cuts Will Negatively Impact Ability to Serve Patients and Keep the Lights On<p>​Dozens of Pennsylvania physicians and their staff reached out to PAMED to share how cuts recently implemented by Highmark would negatively affect patient care and access, as well as their practices and staff. Here are some of the comments we received from Pennsylvania providers.</p> Says: Credentialing Process Burdensome and Costly for Physicians PAMED recently polled members on impacts of of the slow credentialing process. See what physicians said.Physicians;#Practice Administrators;#

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