The Maine Chapter APTA has submitted a bill (LD number not yet assigned) to the Maine State Legislature to regulate prior authorization by insurance carriers.  We are collecting data for the upcoming public hearing on the bill (it has not been scheduled yet).  Please complete the short questionnaire below to assist in our effort to pass this bill.

Prior Authorization Questionnaire_2023

Questionnaire about AIM prior auth practices for purposes of our legislation.

When AIM prior auth is required for a PT eval, how often does AIM deny the eval?
How many visits do you routinely get on the first prior auth request for visits (not just the eval)?
How long does it take you to request and obtain approval the first time?
On the second request for visits (after initial visits have been used), how many visits are typically approved?
On the second request for pre-auth, are the visits auto-approved through the AIM platform or do you have to talk to talk to a peer reviewer or send in records?
How long does it take you to get approval the second time?
On the third request for visits, how many visits are typically approved?
On the third request for pre-auth, are the visits auto-approved through the AIM platform or do you have to talk to talk to a peer reviewer or send in records?
How long does it take you to get approval the third time?
Have you or your patients filed appeals when AIM denies additional visits?
How frequently does AIM/Anthem tell you that prior authorization is required when it is not?
How often does the AIM/Anthem or Availity platform say prior authorization is not required but then your claims get denied because you did not get prior auth?
Have you had MEA Benefits Trust patient claims erroneously denied recently for failure to get prior auth (it is NOT required)?
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