In June, new prior authorization rules from UnitedHealthcare concerning select gastroenterology procedures will take effect, requiring patients and physicians to seek authorization for gastroenterology endoscopy services, including esophagogastroduodenoscopies, capsule endoscopies, diagnostic colonoscopies and surveillance colonoscopies.
Several physician groups, including the American Society for Gastrointestinal Endoscopy and the California Medical Association, have expressed opposition to the changes, citing patient safety concerns and undue physician burden.
UnitedHealthcare begs to differ, saying that these changes will actually improve patient safety by preventing procedure overutilization.
“Prior authorization is an important checkpoint to make sure a service and procedure is safe and clinically appropriate. It also helps ensure that patients don’t pay out of pocket for care they don’t need,” Tracey Lempner, director of communications for UnitedHealthcare, told Becker’s.