In today’s complex health care landscape, timely access to necessary medical services can be paramount to achieving optimal patient health outcomes. You play a critical role in the management of patient care, and your proactive intervention in escalating expedited appeals filed by your patient can be critical when your patient has an urgent medical condition that requires a decision be made quickly.

Please alert us when an expedited appeal requires immediate attention

Health care providers are often the first to identify a need for expedited care. Many medical conditions require timely interventions to prevent complications or deterioration of your patient’s health status. Delays in care can lead to severe repercussions, including emergency department visits, hospitalizations, or long-term disability.

You possess firsthand knowledge of your patient’s medical history, current health condition, and the urgency of their treatment needs. Your ability to quickly advocate for rapid review and prior authorization of care can be essential to help mitigate risks and ensure your patient receives necessary treatment without unnecessary delays.

You can provide essential clinical information and evidence-based rationale for why expedited care is necessary. Your detailed documentation of a patient’s condition, treatment history, and the expected outcomes of timely intervention can strengthen the case for expedited care, and help us to act swiftly and make a timely decision that is clinically justified.

Patient-centered care

By intervening on behalf of your patient during the appeals process, you can help ensure that your patient’s voice is heard and respected. Additionally, this provider‒health plan collaboration fosters a more holistic approach to patient care, where clinical insights inform operational decisions.

Thank you for advocating on your patients’ behalf.

We appreciate your patient advocacy and helping to make it easier for our staff to assess the urgency of an expedited appeal, accelerate decision-making, and reduce patient anxiety associated with waiting for essential care.

Additional information

To learn more about expedited appeals, read this article.