I have a patient who has been in the hospital for days with a GI bleed with difficulty finding the source. The patient has had 4 units of blood transfused over the last few days. The GI doctors don’t want the patient to eat right now and they want the patient on IV medication and the patient needs IV fluids because they can’t drink fluids either.

Well I just got a call from the insurance review person who says that this patient’s insurance company is claiming the patient does not meet criteria to be admitted to the hospital and they won’t pay for the admission and would I like to do a “peer to peer “ with the insurance company doctor