New Prior Auth Reporting Tool

The new ACC Prior Authorization Reporting Tool (www.acc.org/PARtool) is open and available to collect members’ data on inappropriate cardiovascular testing and procedure request denials by insurers and prior authorization vendors. The PARtool is open to all members and their staffs. Please participate to make this successful.

The PARtool will primarily serve as a process for ACC to monitor and identify inconsistent denials by region, payer, prior authorization vendor and modality. Additionally, there will be a focus on “test substitution”- denying an appropriate test request to require another appropriate test.

The 12-question tool will gather information about the practice requestor, payer, prior authorization vendor, de-identified patient indication, modality/procedure requested and overall prior authorization experience. It is important to remember that the tool is NOT collecting patient specific/identifiable information rather details surrounding the prior authorization request. ACC staff will monitor the data on a regular basis to review and identify trends and problem areas for members.

The PARtool will provide an opportunity for ACC to directly see the prior authorization hassle and burdens experienced by cardiologists across the country. With this data, we aim to influence payers and national and state policymakers to improve the prior authorization process, criteria and member experience and delaying in patient care.

Of course, the PARtool’s success is contingent on high member engagement and participation.