Insurers are practicing medicine in these instances - legal precedent to hold then accountable. In peer to peer I document name and contact information of md denying service so the patient can reach them for next steps ➡️ 100% success rate on approvals.
@DGlaucomflecken
@DGlaucomflecken
https://twitter.com/dglaucomflecken/status/1402346739344969730
Legal precedent here are cases re “curbsides” during which md’s giving on the fly advice re patient care have been found to have established a patient md rlsp with liability attaching despite not meeting the patient.
Bc those docs had reason to believe their advice would be followed they were responsible for the consequence. Similarly here insurers have strong reason to believe their decision will affect patient care and are responsible for outcome.
Insurers will argue they are “protecting” patients. Bullshit. (Sorry but that’s the only word I can think to describe). Their contract with patients is to offset costs of care for a monthly fee not to protect them from autonomous decisions they’ve made with their clinicians.
In > 10 yrs I have never seen a care denial result in a benefit to a patient. That’s not to say my care is perfect. Far from it. And I sincerely appreciate m and m and qi for helping me to improve. But insurers have uniformly denied care to increase their profit. Total bullshit.
And in women’s surgical care - the reason they deny services is sooooo far removed from any kind of evidence based medicine. Ugh. One insurer denied a hyst recently bc the patient hadn’t had children. They got a serious earful from me for that one.
(Ok - end of rant)
(Ok - end of rant)
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