Fok leeches of society

Capitalism

Your doctor can appeal it for a peer to peer review with a physician employed by the insurance company. The problem is they are employed by the insurance company and if they authorized every review they'd be out of a job.

Insurance has medical doctors and clinical staffs who look onto it aswell. Just so you know

They can drop a Dr. from insurance if he or she is ordering to many tests. A Doctor has to follow insurance manuel or won't get paid, even if medically necessary.

Hi there! I've just recently started a new job as yours, need to call health insurances to know about the patience current authorization process and such, problem is that I'm from DR and don't speak english too much (I'm better at writting) What do you think? Any advice? A friend of mine told me it isn't that hard as you only need basic to intermediate english level to ask the information you will be needing.

@@johangp1990 The job is easy. You learn as you go. Most of the PAs can be done online through covermymeds.com

Can you help me please? Who do prior authorization on the side of insurance company? Is it a US physician`s, or it can be done outsorser outside of US?

Yup!

no shit it take 4 months

As a pharmacy tech studying to be an actual pharmacist, I can assure you we equally say "fuck you, BCBS". BCBS; Because Capitalizing Bull Shit.

Simple. To make money.

Yup or try other medication that's cheaper if it "doesn't work" then okay fine well give you the medicine. Until next year when you will have to go through the process AGAIN. Aaand every year after that. How wonderful huh. Sorry for what you're going through. Hope things change one day.

It's called the "Golden Rule" He who has the gold makes the rules.

It is true I've had scenarios where I get very frustrated trying to get approval and it takes days for them to review only to get denied. The insurance Co. C.E.O. gets a big Bonos when they can deny services and meds that their peer review deems to expensive or unnecessary.

That's why you have to know the loopholes... And use it to YOUR benefit. They are not on your side... Patients blamed me all the time as an insurance company, though I had nothing to do with access to their life saving drugs... But once they are educated, armed with every necessary tool I've provided them, they are now better equipped to manage their care with confidence and gain access to their life saving medications

Awwe 🥺💘

So when's the murder trial?

@@NeXtarProducts yeah I wish there was...

It happens when someone is bleeding out in E.R. and not one Dr. Wants to take it because there is a risk he won't get paid and the patient can turn a sue him. It really leaves Doctors with hands tied. Who wants to work for free and then get a sued ?

Was there an effective treatment available?

As a physician, I beg you to demand that health insurers STOP putting up "prior authorization" road blocks. You patients need to understand how horrifically time wasting this process is.

I hope you aren't referring to the Canadian healthcare system

The insurance companies!

I knew a patient that had cancer and ins.co. denied C.T. to scan other parts of b ody to check for tumors. They constantly deny the patient the right to be treated with dignity. They already feel sick and then we send spinning in circles waiting for P.A.

Yes and piles of authorization requests. Thank you for noticing most offices are following insurance guidelines only to be eaten alive when a patient thinks we are responsible for denial. If this lengthy process us eliminated patients will be able to expeditiously get services they need. Everything needs to approved by them first,and you wait and wait and wait some more hopefully you don't die waiting.

They want to try their formulary first. Their formulary must be followed or they won't pay the Dr. Or Hospital . They decide if your Dr. ,Hospital or treatment is necessary to validate payment.

We don't have a President Ma'am. Hes a lost cause and ruined this country worse than it was sadly. 😞

Hey did you need any medical certification to perform this job? And did you like it ?

@@cecilferminperez2625 No I didn't require any

@@dwipayandhar5326 because I graduated from high school last year and I would like to try this job but I was hesitating since I only have my high school diploma, thanks for the info!

@@cecilferminperez2625 It depends upon the company ...if they have requirements...some strictly take only science graduate...some don't ...I am from arts so still I had no issue working here ...

@@dwipayandhar5326 oh okay, I found one in my area that only requieres high school diploma and experience, the experience is not “required” but highly recommended

So what's your point...

@@dr.robertmclainmd8456 That this video is misleading or romanticizing medicine and service. And that creating a better world is best done by sticking to truth and accuracy rather than delusion or romantic fantasy.

Health insurance is EXPENSIVE in the U.S. I get it through my job & still pay $150 per paycheck (every 2 weeks). If insurance was free, or cheap, then I can understand them looking to save money. I strongly disagree with your statement that insurance pays "10's of thousands of dollars" when ultimately it is the patient paying . I've been prescribed 180 pills of a certain medication for 6 years. It isn't name brand & it's cheap. One day out of the blue, my pharmacy contacted me informing me that my medication now required a PA. My doctors office does not do prior authorizations claiming it takes too much time & they're denied the majority of the time. I called my insurance company to ask what could be done so I can continue getting my necessary medication. The only choices I was given was to either find a new doctor that does PA's or drastically lower dosage. They told me the max number of pills I could get that would not require a PA is 120. So, basically I was forced to go from 180 pills per month (6 daily) to 120 a month (4 daily).

I agree with James Zee insurance is just a discount card that we buy, then we pay deductible to be able to use that discount card and deductible has gone up so much to buy affordable insurance. Then comes Co- Payments and payments. Insurance companies negotiate the cheaper rates from the doctors and hospitals so squeezed them also then they squeezed the patients to the point where they can not afford treatment and medications. It a very bad situation:(

Mr. Walker, insurance IS screwed up in America! Prior authorization is a horrifying time wasting scheme that health insurers use to deliberately punish physicians for prescribing optimal therapy for their patients. Patients come to us to find out what is the best treatment for their conditions. Unfortunately, many of the almost miraculously effective new medications are horrifyingly expensive, and health insurers DO NOT WANT YOU TO HAVE THEM!!! They brutally punish us physicians for daring to treat patients optimally and correctly. I ask you to take back your offensive statement of "so stop with the pity parties". All Americans need to get engaged and get legislation passed to END PRIOR AUTHORIZATION FOREVER IN AMERICA. If I prescribe an effective and safe FDA approved medication or treatment for its correct FDA approved indication, then that should be the end of the story. Health insurers and pharmacists should AUTHORIZE AND DISPENSE the medication with no more evil road-block prior authorization nonsense. How would you like it if you had to beg for permission (i.e. get a "prior authorization") for every other life purchase you make? What if you wanted to buy milk, but your "insurer" said "no, water is good enough for you". Thank God it hasn't come to that.

The Doctor studied Medicine not economics. The insurance gets the final word.