Proactive Interventions for the Prior Authorization Process-Addressing the High Cost of Radiology Services

Video Transcription

Video Summary

The webinar, hosted by the Association of Community Cancer Centers, focused on the high cost of radiology services in cancer care and how prior authorization barriers create delays, denials, and financial stress for patients and staff. Jennifer Paquette explained that diagnostic radiology often requires prior authorization, forcing patients into outside imaging centers, causing potential misreads, delayed results, and extra burden from transferring records. She also reviewed insurance rules, CMS appropriate use criteria, out-of-pocket costs, and the complexity of managing many payer portals. Two case studies showed how documentation and screening criteria affect approval decisions.  <br /><br />Amy Hoag discussed financial toxicity—the emotional and financial burden of cancer care costs—and how radiology expenses add to treatment, travel, income loss, and daily living hardships. She described current support options such as charity care, foundation grants, and social work referrals, but noted their limitations. Amy emphasized proactive financial navigation, early screening, and coordinated care across “cost silos” to better support patients from diagnosis through survivorship.  <br /><br />Both speakers stressed preparing for the end of the public health emergency and the expected increase in uninsured or underinsured patients.

Asset Caption

In the third webinar, we heard from Jennifer Paquet, RN, BSN, Financial Assistance Patient Care Coordinator Supervisor from Bassett Cancer Institute and Aimee Hoch, MSW, LSW, Oncology Financial Navigator from Grand View Health Cancer Center. We discussed barriers to radiology prior authorizations and provide insights on how to address them.

Jennifer Paquet, RN, BSN
Bassett Cancer Institute

Aimee Hoch, MSW, LSW
Oncology Financial Navigator
Grand View Health Cancer Center

Aimee Hoch, LSW, OSW-C, is a Masters Level Social Worker with 20 plus years of experience in both healthcare and behavioral health. She earned her MSW from Fordham University Lincoln Center. A Financial Navigator for the Oncology Program at Grand View Health, Aimee is an advocate for individuals diagnosed with cancer by meeting them with empathy and connecting them with resources to support them during their most vulnerable times.

Aimee is a consultant for the Cancer Support Community as a Financial Navigation specialist and is a member of their Biosimilar Advisory Board. She is an active member of the Association of Community Cancer Center’s (ACCC) Financial Advocacy Network Advisory Committee and Voice Task Force. She speaks about Financial Toxicity and the role of Financial Navigation in cancer care. Aimee has been a guest on Cancer Buzz TV, Patient Power, and WDVR. She has been featured in publications including Breastcancer.org, Patient Power, and ACCC’s Financial Advocate Spotlight. Aimee has contributed to ACCC’s Patient Assistance and Reimbursement Guide and OncoLink News.

Keywords

biomarker testing

precision medicine stewardship

precision oncology

multidisciplinary workflows

lab vetting

turnaround time

EMR integration

QNS rates

genomic results

prior authorization

radiology services

cancer care

financial toxicity

insurance barriers

diagnostic imaging

patient burden

charity care

financial navigation