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Prior authorizations still coming

  • 1.  Prior authorizations still coming

    Posted 04-08-2020 08:28 AM
    My office is silent as I write this message for your consideration this morning.  I have had to furlough the majority of my staff for a period as my census of patients became too low to justify the additional overhead.  This is a situation I know many of you are facing as well and my heart goes out to you.  This is certainly frustrating but it is not the point of this message.  We are all in a sense suffering for the "greater good".  Or are we?
    Every day I still work through as many of our emails and faxes as possible and a recurring theme continues to play out.  First, I or one of my associates has prescribed a medication.  The pharmacy has that medication and is ready to fill it for the patient.  Yet the insurance company refuses to bend on its ridiculous practice of requiring prior authorizations for nearly everything we write.  I recognize that many of the medications I write are not "life saving" medications, but I am certain I am not the only one with this problem.  Even with a full staff working many hours these prior authorizations were troublesome, but now they are moving toward impossible.
    Physicians have complained of the idiocy surrounding the practice of requiring prior authorizations for so long without any change that I doubt this problem will ever go away.  Perhaps I just wanted to vent, and maybe a few of you out there would like to vent as well.  When this is all over, every major industry is going to claim hardship and ask congress to bail them out.  The insurance industry will be no exception.  If the mood catches you I encourage you to write a short letter to our congressional leaders and explain to them that when they(insurance companies) could have helped out even for a short time by suspending this labor-intensive practice, our lofty insurance agencies chose to drive in the screws.

    Thanks for lending an ear,
    Brett Kockentiet, MD

    Brett Kockentiet
    Affiliated Dermatology & Cosmetic Surgery Center Inc.

  • 2.  RE: Prior authorizations still coming

    Posted 04-09-2020 07:03 AM
    Brett- I agree, the demands insurance authorization has placed on healthcare has exponentially increased over the past 10 yrs.  The process not only adds administrative expenses to physician offices AND insurance companies, it dictates the practice of medicine and risks delaying or missing critical diagnoses.  A patient that I have recently seen for a pathological fracture of their shoulder could have been diagnosed 6 mo ago, however, the MRI that their PCP ordered was "denied" by the insurance company.  This patient's shoulder and possibly life will forever be affected by the insurance company denying their doctor the requested diagnostic MRI.

    Kenneth Westerheide, MD, FAAOS
    Orthopedic ONE