Independence Blue Cross, Penn Medicine piloting program to cut prior authorizations

Independence Blue Cross and Philadelphia-based Penn Medicine are piloting a program that will allow qualifying physicians to skip prior authorization approvals needed for ultrasounds, CT scans and PET scans, The Philadelphia Inquirer reported April 18. 

The pilot program will cover about 1,280 physicians employed at Penn at the Hospital of the University of Pennsylvania, Pennsylvania Hospital, Presbyterian Medical Center, and West Chester, Pa.-based Chester County Hospital, according to the report.  

To qualify, physicians must have a consistent record of ordering medically necessary radiology tests like CT scans and MRIs in a way that is consistent with accepted guidelines. Penn expects the program to eliminate prior authorizations for 24,000 imaging tests annually, accordng to the report. 

Rodrigo Cerdá, MD, Independence's chief medical officer, said if the program proves to be successful, the payer wants to expand it to other health systems, according to the report. 

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