Medicare Advantage Organizations’ denials of prior authorization requests raise flags in HHS report and prompt AOA’s third-party advocacy outreach on behalf of optometry practices.
Direct third-party advocacy remains a critical component of the AOA and affiliates’ mission, helping support practice success by ensuring patients can freely access the broadening scope of eye health and vision care delivered by optometry. But advocacy requires a team effort, and optometry’s advocates have an opportunity this spring to help bring about the payer changes the profession needs.
The agenda for AOA on Capitol Hill April 24-26 will be dominated by issues uppermost on member-doctors’ minds. Open to doctors of optometry and optometry students, register now.
Overpower Payer Issues
The AOA's Third Party Center, working continuously to monitor plan policies and actions, is the profession's payer advocacy nerve center.
Register now for the virtual AOA Payer Advocacy Summit, Nov. 15-16.
The insurer noted 99000-series codes are still subject to E/M review; however, the AOA Third Party Center continues to challenge health plans’ downcoding schemes as inappropriate.
Vision plan policy changes that incited swift AOA and affiliate rebuke have come under Congressional scrutiny, while optometry’s advocates score a win for states.
Despite the climbing cost of high-quality eye health and vision care, vision plans’ low fee schedules have remained flat for decades, creating undesirable consequences for patients and the health care system.
Flawed plan, set to go into effect Sept. 1, reduces doctor and patient choice.
Insurers’ business practices are limiting doctors’ ability to provide care, and the AOA is taking action to hold them accountable.