Why create a website to help providers
avoid peer-to-peer calls?
Because peer-to-peer (P2P) phone calls waste so much physician time and this may affect patient care.
Peer-to-peer phone calls may waste two weeks per physician per year
Prior authorization (PA) for imaging studies has now become a daily routine for most physicians, making it a major administrative burden. With an average p2p lasting 10-15 minutes each, (not counting the time waiting on hold), physicians waste an average of two entire weeks (eighty hours) each year speaking with a medical director. Those two weeks could be spent in better ways: seeing additional patients, relaxing with friends and family, or taking two more weeks of vacation.
The time spent talking to medical directors on the phone invariably leads to frustration. Even when the denial is overturned and approved during the p2p, physicians have that lingering feeling they have just wasted precious office time. P2Ps also divert attention away from your principle task: diagnosing and caring for patients. Just think of what you could do with the extra time if you did not have to perform p2p calls.
This is not what we went into medicine for…
Eliminating p2ps from your workday might also help restore faith in your original decision to become a doctor. Administrative hassles such as prior authorization and p2p calls are major contributors to professional dissatisfaction, physician burnout, depression, and premature retirement.
What I learned as a Medical Director could help doctors avoid P2P phone calls.
For 7 ½ years I worked for a Radiology Benefits Management company serving as medical director.
While reviewing requested imaging studies and performing p2p calls, it became clear to me that many of these denials were avoidable, if only doctors and their office staff understood more about the PA process and made a few easy changes in their office processes. During p2p calls I tried to teach providers some of these tools needed to avoid future denials and p2ps. Unfortunately, there was not enough time during a phone call to make much of a difference.
I began to give talks and lectures to physicians at medical meetings. It was during this time that I realized establishing a website and a blog can reach a larger number of providers.
Now that I no longer work for that RBM, I can spend more time sharing this information. This has become my mission.
You just need the right tools: The Keys to the Castle
Once, while speaking to a provider group, I shared the hints and tips most of which are contained on RBM websites. After my presentation, one physician attending the talk came to me with a suggestion. Instead of calling my information “hints and tips,” he said, why not call them “the Keys to the Castle.” His image of prior authorization was that of an imposing castle with a wall and moat. The tools I gave at that talk served as keys to open that mysterious castle.
But there is nothing magical about these keys; they are not even secrets. They are available on public RBM websites. But if you're like most physicians, scouring RBM websites is the last thing you need to spend your time on. That's why I'm here.
How you can use this site
On this site, I'll share what I learned as a Medical Director, to help other physicians avoid the burden of P2P phone calls. I'll also publish guides and tools you can download to share with your nursing and office staff. Although I worked for one RBM, much of the information I am sharing is common to all RBMs or is a part of another Prior Authorization company. Be sure to subscribe below for these resources, as well as regular updates on guidelines and rules, and how to work within them.
How can I help?
I am available for speaking engagements, consulting and coaching medical groups and office staffs, and personal appearances with local or national specialty societies. Stay tuned for webinars, podcasts, and workshops, as well useful information on this website and blog.