Early this year, Tennant's oncologist agreed he was a good candidate since the largest tumor in his body is in his liver. But that's when his family began fighting another adversary: their health insurer, which decided the treatment was "not medically necessary," according to insurance paperwork.
Health insurers issue millions of denials every year. And like the Tennants, many patients find themselves stuck in a convoluted appeals process marked by long wait times, frustrating customer service encounters, and decisions by medical professionals they've never met who may lack relevant training.
Recent federal and state efforts, as well as changes undertaken by insurance companies themselves, have attempted to improve a 50-year-old system that disproportionately burdens some of the sickest patients at the worst times. And yet many doctors complain that insurance denials are worse than ever as the use of prior authorization has ramped up in recent years, reporting by KFF Health News and NBC News found.
It always pisses me off when an insurance carrier makes a decision that is contrary to what the doctor prescribes as necessary . . . and to make matters worse the carrier goes along with the treatment plan until they decide they don't want to spend any more money on this patient.
In this case, treatment was medically necessary until (in their view) it isn't . . .
Health insurers issue millions of denials every year. And like the Tennants, many patients find themselves stuck in a convoluted appeals process marked by long wait times, frustrating customer service encounters, and decisions by medical professionals they've never met who may lack relevant training.
Recent federal and state efforts, as well as changes undertaken by insurance companies themselves, have attempted to improve a 50-year-old system that disproportionately burdens some of the sickest patients at the worst times. And yet many doctors complain that insurance denials are worse than ever as the use of prior authorization has ramped up in recent years, reporting by KFF Health News and NBC News found.
‘Not Accountable to Anyone’: As Insurers Issue Denials, Some Patients Run Out of Options - KFF Health News
Health insurers issue millions of prior authorization denials every year, leaving many patients stuck in a convoluted appeals process, with little hope of meaningful policy change ahead. For doctors, these denials are frustrating and time-consuming. For patients, they can be devastating.
kffhealthnews.org
It always pisses me off when an insurance carrier makes a decision that is contrary to what the doctor prescribes as necessary . . . and to make matters worse the carrier goes along with the treatment plan until they decide they don't want to spend any more money on this patient.
In this case, treatment was medically necessary until (in their view) it isn't . . .
