To everyone in a similar scenario: the tactic my doctor's office has taught me is to ask, in writing, for:
1) the name, board specialty, and license number of the doctor making the determination the treatment was not medically necessary;
1) the name, board specialty, and license number of the doctor making the determination the treatment was not medically necessary;
Comments
3) proof the doctor making the determination has maintained registration in your specific state and documentation of their meeting all their continuing education requirements;
You are not entitled by law to *all* of these things in most states, but you're entitled to some of them, and you can always ask for them.
Where do we look to see if we might be entitled by law to these things? That way we can cite the law, if they do push back on obtaining that information.
Same for nurses in insurance payrolls.
Repatenting generics and then charging a tech worker’s yearly income is gross.
My brother has MS and they just told him they're denying his existing pre-auth, less than a week before he was supposed to fly to Seattle for treatment.
Yet so very few debtors took the time to dispute, despite our first letter telling them how to do so.
Always dispute!
Saved me a lot of time & money!
They take the insurance gig cause they can't affoed insurance to actually practice.
https://armandalegshow.com/
Thank you so much!
Is there anything healthy about this system? Why should we have to know these things? Why is any of this legal?
When it's a cat and mouse game where the house always wins, what do you think is going to happen?
I am wondering if the decisions these doctors are making, which essentially dictate the specific treatment the patients get (or DON’T get), would subject them to a medical malpractice claim when the patient dies as a consequence of their decisions?
Hmmm.
“We didn’t prevent you from having the treatment, which is a decision between you and your doctor. We just said that we wouldn’t pay for it. You were free to find some other way of paying for it, but that’s not our responsibility.”
Also, a tip for WC claimants: make sure your WC appts only have the ICD-10 code(s) for JUST your injury. (cont)
It's been linked in the replies
Bookmarking this medical advice