The dreaded prior authorization

[Bearcat74]

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If you want to see what you'll be getting yourself into, watch this video of an M.D. trying to get a pre-auth for a CT scan. The insurance companies also require these for many routine meds, and they will drive you absolutely nuts! If you can deal with this, then going into the medical field is going to be a great career choice for you!

http://www.kevinmd.com/blog/2016/06/doctor-endures-pre-authorization-hell-recorded.html

 

[ProfMD]

One of the advantages of being employed by a university - the hospital has people who take care of these calls. I only get involved if the insurance company wants and doctor-to-doctor discussion. These have never taken me more than 5 minutes and have pretty much never been turned down.

 

[sloop]

One of the advantages of being employed by a university - the hospital has people who take care of these calls.

Are they called residents?

I'm being sort of facetious. I mean the true "prior auth" stuff can get handled by other people, but there's a ton of arguing with insurance companies over the phone that goes on at my hospital. A lot of it is the time-honored "Are you ****ing stupid? This patient won't get better in SNF, they need acute rehab" conversation.

I've come to the conclusion that doctors working for insurance companies are often unethical. I kind of see it like doctors participating in executions or the torture of prisoners—sure, it's gonna happen anyway, but the job violates professional ethics. Doctors are not supposed to be playing interference in the treatment of patients by other doctors.

 

[ProfMD]

Are they called residents?

I'm being sort of facetious. I mean the true "prior auth" stuff can get handled by other people, but there's a ton of arguing with insurance companies over the phone that goes on at my hospital. A lot of it is the time-honored "Are you ****ing stupid? This patient won't get better in SNF, they need acute rehab" conversation.

I've come to the conclusion that doctors working for insurance companies are often unethical. I kind of see it like doctors participating in executions or the torture of prisoners—sure, it's gonna happen anyway, but the job violates professional ethics. Doctors are not supposed to be playing interference in the treatment of patients by other doctors.

Most preauth stuff is done by someone in our billing office. I do the doc-to-doc calls myself. Typically the things are end up having to to argue about are imaging.