Something that many physicians do, that I refuse to do: prior authorizations.
I won’t do them.
You might be asking, “Well what if the patient needs an MRI, and it requires a prior authorization”.
I still won’t do it.
If I get wind that a patient of mine is possibly going to get denied for an MRI, I call the patient up, and let them know that the insurance company doesn’t want to pay for it. I put the blame squarely on the insurance company, and let the patient know that they should call them to complain.
“I put the blame squarely on the insurance company, and let the patient know that they should call them to complain.”
The insurance company is the one that refuses to get them the MRI, not me.
As to how they can deny necessary medical imaging by the medical expert that saw them is beyond me.
Sometimes patients complaining will get the study approved.
Sometimes patients complaining (to the insurance company, when a study ordered by the doctor was denied) will get the study approved. Click To Tweet
If not, the patient always has the option to pay cash for an MRI, which is sometimes less than what they would have paid with insurance.
If the insurance denies what I deem necessary as a medical expert (orthopedic surgeon), then that is on them, it’s not on me.
The longer we keep doing prior authorizations, the longer they will exist.