Prior Authorizations (PAs) are a continuing burden on medical practices – and allergy practices are no exception. In the Medical Group Management Association’s 2022 Annual Regulatory Burden Report, PA was considered the most burdensome regulatory issue, with 82% of respondents saying it was very or extremely burdensome.
As the leader in practice management resources for practicing allergists, the College developed our Prior Authorization Toolkit to help allergists simplify and streamline these requests. Our groundbreaking PA appeal letter generators let you create patient-specific appeal letters, complete with scientific references, for common allergy medication/disease combinations in just a few easy steps. Simply enter 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 in Microsoft Word.
PA appeal letters are currently available for the following medication/disease combinations:
| Asthma | Nasal Polyps | Other |
|---|---|---|
| Cinqair | Dupixent | Odactra/Allergic Rhinitis |
| Dupixent | Xhance | Dupixent/Atopic Dermatitis |
| Fasenra | Xolair/Urticaria | |
| Nucala | Palforzia/Peanut Allergy | |
| Tezspire | ||
| Xolair |
The toolkit also contains tips and tricks for staff and patients to make PAs more efficient, developed by a team of allergy prior authorization experts.
The Prior Authorization Toolkit continues to be one of the College’s most popular toolkits. Its usefulness was discussed at a recent House of Delegates (HOD) meeting. “I am very grateful for the Prior Authorization Toolkit. It has saved me hours of administrative work and frustration,” said Sheila M. Bonilla, MD, FACAAI. “It’s easy to generate prior authorization appeal letters complete with all the required references. The fastest turnaround time for me was one business day for approval! Amazing!”
Travis Miller, MD, FACAAI, vice-chair of the Advocacy Council said, “The College’s Prior Authorization Toolkit saves our office staff hours of extra work and streamlines the PA approval process. We frequently turn to ACAAI for support with toolkits, and they make the practice of allergy easier.”
Reducing PA burdens continues to be one of the Advocacy Council’s top priorities, and we are beginning to see positive changes. Following College advocacy on this issue, CMS recently published a final rule that reduces the PA burden associated with Medicare Advantage plans. And at the recent Advocacy Council Strike Force meetings in Washington, DC, streamlining and standardizing prior authorizations was one of our top advocacy priorities.
Don’t struggle unnecessarily with prior authorizations in your practice. Use the College’s Prior Authorization Toolkit to streamline your processes and get approvals faster!
