And you can leverage that in your appeal letter.
Especially when you have a pissy provider who doesn’t like being told “no.”
The insurance company is going to have a doctor who said you don’t need it.
To add on to this, my psychologist told me that he’s had antipsychotic meds denied by a urologist before, because the insurance companies often don’t actually care what field the doctor is in. All they care about is getting to say “a doctor” reviewed it.
Adulated_Aspersion@lemmy.world 10 hours ago
Tollana1234567@lemmy.today 18 hours ago
then they have teams to review the first insurance agent approved your medications, and sometimes a team to review that teams decision of said medication. they will do this til you give up.
uberfreeza@lemmy.world 7 hours ago
I have a relative who is a doctor. Had a claim denied once from someone that was not a doctor. Next: denied by someone not actively practicing in the field. Then denied by a doctor with no experience in that specialty. Only after all of that was it approved. They’ve also been picky about order of operations, such as not covering an MRI because there wasn’t also an order for a CT.