Amy Funkenstein, MD, from Brown University, in Providence, RI, and colleagues examined whether the prior authorization requirement added to the overall length of a psychiatric patient's wait by tabulating the length of stay in the Cambridge Health Alliance psychiatric emergency department and amount of time spent obtaining authorization from the insurer. Data were collected for 53 patients who were mainly Caucasian and aged 7 to 68 years.
The researchers found that the average time from first contact with the insurance company to granting or denial of authorization was 38 minutes. Half of the authorization requests took less than 20 minutes to be approved, while 10 percent took an hour or more and one case took five hours. The median time spent in the emergency department was 8.5 hours.
"Our findings indicate that the need to obtain prior authorization does not add much time to the total time psychiatric patients spend in emergency departments," the authors write. "Furthermore, if the preauthorization process does help contain costs, it does so largely through a deterrent effect -- we call it 'rationing by hassle factor' -- given that in all but one case physician requests for authorization were granted."