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priorauthnightmare.bsky.social
Account run by Physicians to document actual physician accounts of the atrocious behavior that insurance companies will resort to in order to deny patients care.
16 posts 119 followers 309 following
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Posts 21 Comments 4

30% of surveyed radiation oncologists said #priorauthorization has caused emergency room visits, hospitalization or permanent disability for their patients. 7% said it led or contributed to a patient’s death. This data is clear. We need to #fixPriorAuth www.astro.org/news-and-pub...

submitted 182 days ago • 4 comments

laugh or cry? #pharmacy #priorauth #primarycare edition: "Fax from the pharmacy for Duloxetine 40mg caps stating this is not covered. Per insurance, this drug requires a PA. Please consider switching to Duloxetine 20mg caps taking 2 a day."

submitted 787 days ago • 0 comments

Today I saw a patient who needs a PET scan to help us figure out how to most safely and effectively biopsy her cancer PET scan appointment available Monday but was told it would be at least 2 weeks because of #priorauth This is not how it is supposed to work @MedicineForward

submitted 1079 days ago • 0 comments

Just got a phone call from my primary care doc friend - their patient suddenly requires #priorauth for glargine. INSULIN GLARGINE. What in the actual bleeping bleep bleep. Incidentally, patient has UHC. Unacceptable. #medsky #endocrinesky #primarycare

submitted 171 days ago • 0 comments

#medsky the latest turn of the screw in #priorauth is your peer refusing to identify themselves due to "safety concerns." Respecting their safety, ask 4 a supervisor. Or, ask for another identifier, like an employee ID. Get something. If they deny reasonable care, contact your congressperson 1/2

submitted 140 days ago • 2 comments

Real case: 32 week pregnant patient with raving bacterial vaginosis had her Flagyl denied. BV can cause preterm labor and serious complications. GoodRx cost of drug: less than $20.

submitted 118 days ago • 0 comments

Yup and what are the chances that it will still be denied and will require an hour long phone call from the provider? Nearing 100% I'm sure.

submitted 118 days ago • 0 comments

Our seventh most-read story of this year: When companies like Aetna or UnitedHealthcare want to rein in costs, they turn to EviCore, whose business model depends on turning down payments for care recommended by doctors for their patients. Read more (published October) ⬇️

submitted 159 days ago • 159 comments

Brilinta (ticagrelor) is a medication that makes platelets less "sticky", ie stops clots. Used after someone has a stent placed in their coronary artery. NOT taking Brilinta can lead to a stent thrombosis: a blood clot inside the stent that was placed. Leading to another heart attack. Or death.

submitted 159 days ago • 0 comments

Even when we've made our case to them and they've approved, they still try again to not pay for appropriate care.

submitted 160 days ago • 0 comments

This was denied I did everything I was asked This is a necessary generic med The system is broken I am broken

submitted 168 days ago • 27 comments

So even if we get a prior authorization you might not pay us? Cool and good.

submitted 169 days ago • 2 comments

submitted 169 days ago • 0 comments

submitted 169 days ago • 0 comments

Explain to me how someone with no medical training gets to tell us how to practice medicine?

submitted 169 days ago • 0 comments

Adult ID: patient stable with undetectable HIV viral load who has been on a given med for YEARS. Suddenly needs PA that is denied despite peer review. Patient with invasive fungal infection who needs Cresemba. Denied. You can use fluconazole (which doesn't work for anything other than candida).

submitted 169 days ago • 0 comments

A pediatrician shared that an MRI ordered on a child for neck pain showed a slight glimpse of a brain tumor at the base of the brain. Called by imaging center for order for MRI brain. Insurance company denied until a Peer to Peer and PA was done while the child was still in the MRI scanner.

submitted 169 days ago • 0 comments

From a pediatric Gi physician. It's not just the adult lives they're willing to sacrifice.

submitted 169 days ago • 0 comments

Apparently they won't tell us how to practice medicine. They just won't pay for what we suggest.

submitted 169 days ago • 0 comments

Not even the death of their CEO can make them change their ways

submitted 176 days ago • 13 comments

The American Medical Association surveyed doctors about insurance “prior authorizations” and found: 41 prior auths per doctor per week 13 hours spent per week on prior auths 24% reported hospitalizations due to delays from prior auths 8% reported disability/deaths due to delays from prior auths

submitted 176 days ago • 33 comments