Last month, I shared my tale of getting a letter in the mail partially denying approval for my wife’s cancer surgery. The “prior authorization” process had done us in, just 36 hours before the operation was scheduled to take place.
My wife got the procedure anyway. She’s healthy now and we eventually paid the thousands of dollars that the high-deductible plan we had chosen required of us.
But we were caught unaware, and I suggested that doctors had a role to play in warning patients about the possibility of receiving unexpected denial letters, even as insurance companies bear most of the blame. This is especially true now that Medicare is planning to conduct a prior authorization pilot program in six states next year.
Some readers didn’t like my suggestion that medical offices ought to help explain the prior authorization system, doctors especially. I asked for feedback via our Your Money newsletter, and they gave it to me.
“My god, you really don’t get it do you,” said one retired cardiologist.
“It is entitled and quite frankly obnoxious to think that is our job to be expected to explain why an infringement on our medical decision-making has occurred,” said a neurosurgeon.
“You are a big boy,” the spouse of a retired plastic surgeon reminded me. “You were just making your problem somebody else’s problem, which is so typical for so many people.”
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The post A Message From Your Doctor About the Prior Authorization Process appeared first on New York Times.
