Plans have members who find themselves in need of specific, specialized services, such as physical therapy, occupational therapy, long term care, skilled nursing, home health care and advanced imaging. Because of the cost and clinical specificity of the services required, plans require that members and providers coordinate with the plan before authorizing payment for the services.
While the authorization process is not always simple for the plan and the providers, for patients, it is confusing, time-consuming, and frustrating.
