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Insurance Prior Authorization Doesn't Up Psych ER Stay

Insurance Prior Authorization Doesn't Up Psych ER Stay

Average of 38 minutes needed to receive insurance authorization for admission

THURSDAY, April 25 (HealthDay News) -- For psychiatric patients, the requirement to obtain authorization from insurance companies prior to admission does not seem to add to the total time spent in emergency departments, according to a study published in the May issue of the Annals of Emergency Medicine.

Amy Funkenstein, M.D., from Brown University in Providence, R.I., and colleagues examined whether the prior authorization requirement added to the overall length of a psychiatric patient's wait by tabulating the length of stay in the Cambridge Health Alliance psychiatric emergency department and amount of time spent obtaining authorization from the insurer. Data were collected for 53 patients who were mainly Caucasian and aged 7 to 68 years.

The researchers found that the average time from first contact with the insurance company to granting or denial of authorization was 38 minutes. Half of the authorization requests took less than 20 minutes to be approved, while 10 percent took an hour or more and one case took five hours. The median time spent in the emergency department was 8.5 hours.

"Our findings indicate that the need to obtain prior authorization does not add much time to the total time psychiatric patients spend in emergency departments," the authors write. "Furthermore, if the preauthorization process does help contain costs, it does so largely through a deterrent effect -- we call it 'rationing by hassle factor' -- given that in all but one case physician requests for authorization were granted."

Full Text (http://www.annemergmed.com/article/S0196-0644(12)01706-4/fulltext )