• 0 Posts
  • 1 Comment
Joined 1 year ago
cake
Cake day: July 2nd, 2023

help-circle
  • Even if a claim gets denied the fact that it was submitted means you already got the treatment.

    That’s quite often not true. There are tons of procedures/tests/etc that don’t get run until a “prior authorization” has been granted by the insurance company. Also medications and durable medical equipment are not dispensed until insurance has been approved. If the prior auth is not granted or the medication is not covered, they usually will not be performed/provided unless the patient pays up front, and without the negotiating power of the insurance company, the patient will be paying 5 to 10 times what the insurance company would have paid.

    I’ve personally been dealing with medical issues the past 3 months and the amount of prior auths I’ve seen go by is astounding. Tomorrow I actually go in for some more tests that they couldn’t do a few weeks ago because these ones in particular needed some prior auths that are harder to get.