@sarahkliff the lack of transparency with these things, even/especially for docs when we call, is maddening.
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@sarahkliff but have you considered the possibility that your insurer is trolling you for trying to leave the health care beatThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff@matthewherper Sounds Orwellian.Thanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff Are you purposely not naming the carrier? Airing legitiate gripes can help your case & perhaps policy for others.@matthewherperThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff Been there as an MD on many UR calls: "Your patient doesn't meet our criteria" Me: What is the criteria? Response: "Ours."Thanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff they don't know the guidelines. Half the time the peer to peer doc u speak to doesn't even know what the test you're ordering isThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff have you checked medical policy? Most bcbs plans have a medical policy you can search the procedure code inThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff who is your insurance carrier? Usually a note to the head of underwriting can grease the wheel. Sucks to go that route though.Thanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff that is the same answer they give dr and hospital eventually they let you know Milliman guidelines, Interqual but not specificThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff You have a legal right to request the guidelines in writing btwThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff pretty sure they're required to provide all evidence and materials used for making adverse benefit determinationsThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff ask to see their medical policiesThanks. Twitter will use this to make your timeline better. UndoUndo
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@sarahkliff "if we told you we'd have to kill you. and if we don't tell you, we will kill you. we win, either way." wish i were joking.Thanks. Twitter will use this to make your timeline better. UndoUndo
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