It happened overnight, and all it took was a shift in policy at one insurance company.
On July 1, 2021, Aetna instituted a requirement for prior authorization on all cataract surgeries. Jennifer Howe, a billing and coding specialist at Ophthalmic Surgeons & Consultants of Ohio, said the impact was immediate.
“In June, everything was going smooth,” she said. “On July 1, it was, ‘Follow our demands or you won’t get approved.’”
It was not the first time prior authorization made its way into ophthalmology, but physicians see it as a sign of overreach by