VolsDoc81TX
Bleeding Orange since 1962
- Joined
- Apr 3, 2011
- Messages
- 13,036
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It's my understanding that even through UH, that big Insurance and Pharma increased profits. Not here to argue that. Just that, Big Insurance playing God has taken access away from people who needed certain medications in lieu of what THEY determine is best medication. Even new approved chemotherapy drugs.If the doc puts mass (potential tumor) insurance won’t deny. Maybe a specialist referral would also help.
Insurance company inappropriate denials for diagnostic testing is pushing the medical community to sometimes practice inappropriate medicine. Anytime I get a denial, my pre-authorization people know request the insurance guidelines for the particular diagnostic test and for the diagnosis. Once you know their guidelines, it’s easy to use their guidelines against them. Many docs are so overwhelmed that they just concede it as a denial and move to plan B.
It pisses me off so much (having an insurance act like they know medicine better than I do) that I spend the time to word the note that totally complies. My denial rate is very low because I don’t like to lose to the villains.
I actually relish the peer to peer calls. I enjoy letting the mercenary insurance doc know that I know their guidelines better than they do.
One of the many reasons that I live in VN past…
It’s bc of the salary cap….. more times than not it takes a dominate qb…… the only problem is that they are way over paid and most teams can’t afford a good team around them once they get the huge contract….. it’s why Big ben won his while he was young….. same for Aaron Rogers….. one of the keys to Brady winning like he has….. he typically takes less money.Makes the NFL way more fun to watch than the college football playoff. Never thought I would ever say that but that is the reality. Hopefully the transfer portal evens up the talent discrepancy in the coming years