Dr. Patricia A. Kirk, Podiatrist



Saturday, January 14, 2012

More about PA's "Prior Authorization"

For many patients and doctors offices this is a very difficult area!  Patients and doctors assume that if they A. Evaluated you  B. Come up with a diagnosis C. Come up with a treatment plan, then this will all occur.  This could not be further from the truth.  Every insurance company is different.  Even if you and another person have blue/cross or united health care.  They many have very different benefits.  Even if you work for the same company as another patient, they may have selected a "lesser" plan.  At times an MRI will be approved that day with no more then a list of diagnoses.  Other times they may want office notes.  Still others the doctor may need to have a physician to physician peer review.  This may all take a day or a week, depending upon schedules and when this can be accomplished between other patients.  Prior authorizations are required for some x-rays, MRI's, cat scans, durable medical equipment, medications and any other services that your insurance deems necessary.  It is important for each person to check their coverage and work with the doctors to get these approvals.   Although it may be very stressful for patients, remember that the doctor does want you to have this service and they are working on prior authorizations for other patients as well!

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