Disease doesn’t ask permission before invading a body, but the diseased must often seek permission before trying to remove it.
Unwelcome to the strange, infuriating world of prior authorization, where doctors must get approval from health insurance companies before performing big procedures or prescribing certain medications.
About half of Americans with insurance have needed their insurer’s blessing for services or treatments in the last two years, according to a poll from KFF, a health research group. Among that group, 34 percent said it was somewhat difficult to navigate the process while 13 percent said it was very difficult.
If you know, you know. And if you don’t, you should. You don’t want to be learning about prior authorization as you’re coming to grips with a bad diagnosis, as my family just did.
On Dec. 9, my wife had a mastectomy for breast cancer plus reconstructive surgery. The night of Dec. 7, a Saturday, we found a letter in the mailbox from UnitedHealthcare stating that prior authorization for the operation was partially denied.
Our minds raced: If the denial stood, the cost could upend our financial lives and years of careful planning. Good luck to us, trying to sort this out on Sunday before we were supposed to show up at the hospital in the predawn hours on Monday. Should we even show up at all?
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The post Insurance Companies Send Chilling Letters Just Before Surgery. But Why? appeared first on New York Times.
