Are you frustrated with administrative headaches and how they impact your patients? Have you faced denials for a care plan within standard practice for a patient?
We want to hear your story!
As NCMS continues to push for passage of HB 649 in the coming legislative session, we need to hear how you and your patients have been impacted by prior authorization.
We are looking for stories from physicians to highlight and draw attention to this issue that is impacting the health of so many North Carolinians.
Please complete this quick survey so we can share your stories with legislators and tell them how Prior Authorization is negatively impacting the lives of North Carolinians!
As a pediatrician, managing ADHD sometimes requires us to treat younger children. Many of those younger children do have other historical issues like maternal drug usage so behavioral issues are expected. United HealthCare Medicaid WILL NOT approve medication for these children and others push back on it even though it is clinically indicated and even though there are good guidelines from the AAP about treating younger children. They say the answer is behavioral therapy, which I cannot get in my small town. Hands tied, children suffering when we have good therapy.
We are a small private physician owned Ophthalmology practice with 8 providers. We have 2 full time employees whose sole responsibility is verifying benefits and obtaining authorizations for procedures. In addition to obtaining authorizations, we must determine whether step therapy measures have been met when required by the payer.
The really frustrating part is after following the rules and obtaining an authorization for a procedure, the insurance companies will tell you having an authorization is not a guarantee of payment.
So, providers follow the rules established by the insurance companies, and their claims can still be denied.