fraud in medicine: prior authorization I

I reblog because these are “real folks” issues and not reality shows shenanigans. #WysWaysofWellness

KO Rural Mad As Hell Blog

Prior authorization is where, in the insane United States medical system, the doctor orders a test or medicine. The insurance requires “prior authorization”, that is, the doctor or their office have to call or go on line to fill out forms to get the prior authorization. Otherwise the test or therapy or medicine or even surgery will not be covered by the insurance and the patient eats the bill. Over 60% of bankruptcies in the US are now over medical bills*.

In most doctors’ offices, the prior authorization is done in the back rooms. Employees are on the computer or on the phone trying to obtain the permission, the code number, the magic words that will help the patient. This is a HUGE business and a scam as well. Physicians for a National Health Care Program estimated in 2011 that it costs at least $82,975 PER PHYSICIAN PER YEAR to…

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Wysjoyfulcompany

WysJoyFul Company Ministering Speaker, Host Wy's Ways of Wellness Radio blogtalk with focus on Wellness Awareness and EOL/ QOL with grief situations and Cancer Care Communications for National Patient Advocacy, Tennessee Cancer Coalition and Memphis Breast Cancer Coalition. Retired RN after 50 years now a Caregiver for family member.