Prior authorizations are the bane of my existence. If I have an obese diabetic with heart disease and decide that a GLP-1 is an appropriate therapy, who are health plans to disagree with my conclusion?
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If only there was one single organization which decided which treatments were cost effective and appropriate and the criteria for using them... It must create a lot of unnecessary bureaucracy having unclear systems that clinicians have to navigate and get approvals for...
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I'd never heard of this before. Luckily, among the insurance company explanations of why they are great, was a wikipedia article giving a more general explanation.
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Yep, was to have to have a repeat CT due to a return of pain following a esophageal perforation. My doctor office got it all set up but due to how close I have had a CT prior it needed additional authentication. So instead I went to the ER and had it done there.
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If you think about it, not needing prior auth might get some cancers diagnosed earlier, where less treatment is necessary and a much less expensive treatment over all. Avoid advanced cancer and you save a bundle! Let Dr. G operate earlier and skip the chemo.
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