Sunday, December 15, 2019

Listen to the Experts | Live Long and Prosper

Listen to the Experts | Live Long and Prosper

Listen to the Experts


Remember that time you called your health insurance company because they denied your claim…
You probably thought, “why should an insurance company representative deny or attempt to deny coverage for something prescribed by my family doctor? What expertise do insurance company workers have in the field of medicine?”
A recent article in the Washington Post by Dr. William E. Bennett Jr., associate professor of pediatrics at Indiana University’s School of Medicine, highlights part of the problem…
We know how important it is to have insurance so that we can get health care. As a physician, parent and patient, I cannot overemphasize that having insurance is not enough.

As a gastroenterologist, I often prescribe expensive medications or tests for my patients. But for insurance companies to cover those treatments, I must submit a “prior authorization” to the companies, and it can take days or weeks to hear back. If the insurance company denies coverage, which occurs frequently, I have the option of setting up a special type of physician-to-physician appeal called a “peer-to-peer.”
Here’s the thing: After a few minutes of pleasant chat with a doctor or pharmacist working for the insurance company, they almost always CONTINUE READING: Listen to the Experts | Live Long and Prosper