Pre-authorization for pediatric knee MRI adds no value to specialist referral
Does the insurance pre-authorization process help weed out pediatric patients who have knee abnormalities that aren’t serious enough to warrant an MRI?
No, it sure doesn’t—at least when the patient is referred by a pediatric orthopedist, according to a study published online Dec. 5 in Skeletal Radiology.
Drew Pierce, MD, and colleagues at Texas Children’s Hospital reviewed the cases of 124 children who had such specialist referrals for the scan.
Patients who underwent insurance pre-authorization comprised the study group. Those who didn’t were the control.
Pierce and team found the two groups had no statistically significant difference in surgically significant findings on MRI (p = 0.92) or in whether the patient required surgery (p = 0.6), according to the study abstract.
“In this population, there is no difference in the likelihood of an abnormal knee MRI demonstrating surgically significant findings or referral to surgery in patients who did and those who did not undergo an insurance pre-authorization process when patients are referred from a pediatric orthopedic specialist,” the authors write.
The insurance pre-authorization process, they add, “does not appear to have an impact on patient diagnosis and treatment and may unnecessarily add bureaucracy and costs.”
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.