I hope whoever thought of "peer to peer" prior auth requirements has a special place in outer darkness

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Jun 1, 2021
1:30:03pm

5150man All-American

I hope whoever thought of "peer to peer" prior auth requirements has a special place in outer darkness

I've never had one denied. Never had one that I said anything more than was in my note. Never had one where I've talked to a "peer". Just got off the phone with a gynecologist to get a C-spine MRI ordered for worsening arm weakness after 6 weeks of PT.

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5150man

Bio page: 5150man
Joined: Dec 1, 2001
Last login: Apr 25, 2024
Total posts: 2,915 (47 FO)

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Messages

Author

Time

I hope whoever thought of "peer to peer" prior auth requirements has a special place in outer darkness

5150man All-American

6/1/21 1:30pm

I’ve got one scheduled for tomorrow for a head MRI for proptosis with pain

scottpete

6/1/21 1:34pm

I had one last month but he was a CT Surgeon and it was just personal

cougfanz

6/1/21 1:35pm

RE: I had one last month but he was a CT Surgeon and it was just personal

SJS

6/1/21 2:03pm

I work for insurance and I hate doing them. Never initiated by us though...it's

WhirleyPop

6/1/21 1:41pm

My suspicion is the doctor is requesting it because it was denied by the insurer

bluecheese

6/1/21 2:03pm

I like asking for peer-to-peer because often the drug is magically approved without actually doing the meeting.

SaturdaySpecialDay

6/1/21 2:15pm

As an outsider/consumer this is fascinating to me. I've never understood what goes into prior authorizations.

IdahoCoug

6/1/21 1:55pm

It's mostly reflexive denials for drugs, diagnostics, and procedures that are expensive. Insurance companies create

SaturdaySpecialDay

6/1/21 2:17pm

I had to get a CT in Dec. for a 6 month check after getting a cancerous tumor removed last summer.

IdahoCoug

6/1/21 2:23pm

It’s one of those things where a patient will complain about a $250 office

cougfanz

6/1/21 2:37pm

I would love that job. How do I get it?

SJS

6/1/21 2:01pm

Yeah. After 10 minutes on hold today she says “I reviewed your note and everything looks good. Here’s your approval #”

5150man

6/1/21 2:48pm

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