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!

Cost for the doctor to see you!

Recently Shopdme posted a great article breaking down how much your doctor actually makes when you go in.
The approximate breakdown of a $100 new-patient appointment:
$9 for malpractice insurance
$4 for equipment and maintenance
$8 for supplies
$6 for rent and utilities
$10 for office expenses such as telephones, accounting fees, advertising, medical journals, licenses, and taxes
$28 for staff salaries and benefits
$35 for the doctor
This does not include billing costs, legal fees if needed, the cost of implementing electronic health records or the cost of new equipment to keep up with the changes in medicine.
Most doctors graduate with large student loans.
I personally pay $2400 a month in student loans and have been for over 11 years.  This means that I must see 69 patients a month just to cover my student loans.  Then I can start earning money to cover food, housing, clothing, car costs, health insurance, and other expenses.  If this cost $3000/month, it would take another 90 patients a month to see.  That's 159 total.  Reimbursement is lower for established patients.  This doesn't include day care if the doctor has children or the cost of repairing equipment or their car.
The next time that you come in to your doctor.  Please don't say, well, you're a doctor you can afford it.  They have sacrificed many years of their lives and are usually in serious debt, to take care of people!