Improving the Efficiency of Pediatric Spinal Fusion Precertification.

ABSTRACT:

Background

Precertification is a method implemented by insurance to reduce unnecessary spending. Unintended consequences include time and resources used to obtain precertification or appealing a denial. There was a perceived increase in denials and peer-to-peer interactions in our pediatric spine center during 2022. This quality improvement project was developed to reduce the burden of time and resources designated to these appeals.

Methods

A Pareto analysis of the causes leading to spinal fusion denials was performed. The team brainstormed and developed a key driver diagram and proposed interventions. Then standard plan-do-study-act cycles were observed to evaluate the effects of the interventions. The interventions implemented included a standardized preoperative template.

SUBMITTER: McGee L 

PROVIDER: S-EPMC12857389 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature