Denied? Make Insurance Gatekeepers Responsible Too

“Snippets from the frontline” sent in from Gene Uzawa Dorio, M.D.

You’ve been told surgery required to repair a herniated disc has been denied; a mammogram to evaluate a new lump won’t be allowed; or you must be discharged from the hospital because an insurance company doctor you have never met will not approve further hospitalization.

As my patient’s advocate, I frequently must discuss their care with insurance doctors in peer-to-peer phone conversations. This is what I do starting this conversation: I get the doctor’s name; in what state they are licensed; their specialty; and tell them their name will be placed on the patient’s record as being a participant in medical decision-making.

With that, they must weigh their medical versus financial judgement, and know they might be subject to the same accountability I face. Does this make a difference? Sometimes.

Medical decision-making has been removed from your doctor and given to distant paper pushers of the insurance industry. Urge your physician in their peer-to-peer conversations to make insurance doctors responsible too.

Gene Uzawa Dorio, M.D.

Comments: http://scvphysicianreport.com/2017/07/29/doctors-diary-july-29-2017/

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Real Stories of the ACA nightmare # 10 – “Free” care is awfully expensive

“I saw a patient that I met for the first time three months ago who is originally from Canada. She was in for her pre-op visit. She is in awe of the fact that she got surgery in three months. In Canada under a single payer system it would have taken at least three years she said. And her income tax rate was at about 50% to cover the programs.”

Posted with permission

Canadian Healthcare crisis: Gate Keeping for Whom?

Dr. Craig M. Wax interviews Canadian physician Dr. Merrilee Fullerton on Your Health Matters #YHM on Rowan Radio 89.7 WGLS FM (Show podcast page http://m.wgls.rowan.edu/?feed=YOUR_HEALTH_MATTERS). She reveals how decades of socialized medicine in Canada have led – not to universal care – but to widespread scarcity and rationing exacerbated by the outlawing of freemarket individual care. Canadian patients have until now been able to escape this rationing by crossing border into the U.S.  However, under ObamaCare, the abundance of care here may no longer be available.
Click on the link for the YouTube version.