Help for prior authorizations is here

November 20, 2017

Prior authorizations are an increasing burden on medical practices – and allergy practices are no exception. According to a recent survey by the AMA, medical practices reported completing an average of 37 prior authorization requests per physician per week, for a total of over 16 hours of physician and staff time! And over a third of respondents have staff dedicated exclusively to working on prior authorizations.

The College understands the enormous problem prior authorizations create for allergy practices and partnered with Allergy and Asthma Network to develop a new member benefit: a prior authorization toolkit to simplify and streamline these requests. The toolkit is sponsored by Teva Respiratory.

A team of allergy prior authorization experts created a set of tips and tricks for staff and patients to make prior authorizations more efficient. The crown jewel of the toolkit is an online prior authorization appeal letter generator, which lets you create customized appeal letters for specific medication/disease combinations in a few easy steps. Simply enter in patient and insurance company information, including past treatments that were unsuccessful and/or alternative treatments recommended by the insurance company, and a customizable appeal letter is generated.

“Experts from our Asthma and Dermatology Committees created evidence-based appeal letters complete with literature references and patient-specific details,” noted Michael Blaiss, MD, FACAAI, ACAAI Executive Medical Director.

Appeal letters are currently available for the following medication/disease combinations:

  • Cinqair/asthma
  • Dupixent/atopic dermatitis
  • Xolair/urticaria

Nucala/asthma and Xolair/asthma will be added soon, and more combinations are planned for 2018.

Preliminary feedback on the new appeal letter generator tool has been extremely positive. Of the small group of allergists who tested it, 100% said they would use it in their practice, and 80% said it was easy to use.

Try it out and contact us with your feedback. In particular, let us know if there are medications or procedures continually requiring appeals that should be added to our list.   

Help streamline prior authorizations and reduce this burden on your practice: check out our prior authorization toolkit and prior authorization appeal letter generator today!