this post was submitted on 04 Dec 2023
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For future reference:
Have your doctor write the literal phrase "medically necessary" on the order. If denied, contact the insurer and ask for the License Number of the Doctor who refuted the necessity. Keep in mind, if they're NOT a doctor it is ILLEGAL for them to make a medical decision.
If they actually get back to you with a license number, you can use that to pull the credentials of the person denying the claim. Present that information to your doctor and I'm sure they'll help write you up a nice paper to send into the medical review board of the state they're licensed in.
I've had to use this method twice with my wife's healthcare. Approvals came within an hour of requesting the license number of the person on their end making medical decisions. The key being the phrase. A doctor's order, or prescription, is a legal document. Your doc putting that phrase means "I believe in this treatment so much, I'm willing to bet my license that they need it."
YMMV as I've only had to deal with BlueCross and they hate when I call.
yeah, thanks. I know most of the tricks now with cigna and bluecross. i just hate dealing with it and it shouldn’t be necessary.
feels good to vent though.
Great trick, thanks for this.