Researchers Recommendations:

  • 1Create a web portal for all stakeholders with:
    • /On-line electronic claims process for PA claims (ePA)
    • /A repository of clinical evidence for payers
    • /Lists of PA drugs by payer
    • /Claim forms for PA drugs.
  • 2Improve transparency and create standardization in the workflow process.
  • 3Provide clear avenues within payers for appeal.
  • 4Develop industry grandfathering standards for PA.
  • 5Identify common metrics and reporting for payers as well as evaluations for physicians, patients and patient navigators.
  • 6Management by an independent agency.

Blogs

Addressing the Backlog of Cancer Patients

Canadians with cancer have been experiencing longer times to diagnosis and medical treatment during the pandemic.

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Prior Authorization Q&A – What You Need to Know

On the November 26, 2020 Benefits Breakfast Club webinar experts addressed innovations in oncology and the role of prior authorization (PA), including the many challenges of a largely paper-based PA process.

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Working Towards New Solutions in Prior Authorization

Did you follow the Simplify Prior Authorization (SPA) initiative in the first half of 2021 after the release of the white paper on prior authorization (PA) in November 2020?

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