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- Apr 16, 2004
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Here’s some advice from a senior medical director from a leading prior auth company.
You know, those guys who make you wait one week to do a P2P because you wanted to do SRS on a solitary brain met and the nurse reviewer said she can authorize it right away if you do it “by 3D.”
Then the P2P guy says, sorry prostate cancer brain mets are excluded from our SRS policy. You can appeal if you’d like.
Those guys have nothing to do with your burn out I’m sure.
Not to be presumptuous but I will go ahead and answer the two questions he posed:
1. Prior authorization. You used to have to deal with this abomination for HMOs/PPOs only but now we need it for those lovely Medicare Advantage patients.
2. Quit clinical medicine and join Evolent.
You know, those guys who make you wait one week to do a P2P because you wanted to do SRS on a solitary brain met and the nurse reviewer said she can authorize it right away if you do it “by 3D.”
Then the P2P guy says, sorry prostate cancer brain mets are excluded from our SRS policy. You can appeal if you’d like.
Those guys have nothing to do with your burn out I’m sure.
Not to be presumptuous but I will go ahead and answer the two questions he posed:
1. Prior authorization. You used to have to deal with this abomination for HMOs/PPOs only but now we need it for those lovely Medicare Advantage patients.
2. Quit clinical medicine and join Evolent.
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