Skip to main content

Prior Authorizations — the bane of most medical offices

Prior Authorizations have been used for years by insurance companies and pharmacy benefit mangers (PBM’s) to deny or delay medications, imaging, treatments, surgeries, etc. for their insured patient, their own client. But really, they don’t care, and never have. Once they get your money, supposedly to pay for such care, they think of it as THEIR money and they get REAL stingy with it! And you thought Ebeneezer Scrooge was bad.

These money-grubbing syndicates rank their priorities in this manner:

1. CEO and executive managerial staff salaries, benefits, perks, and bonuses!

2. Stockholder dividends and bonuses.

3. Corporate payoffs to politicians and organizations that make laws to help them do what they want to make more profits!

4. Payouts to the PBM’s to maintain their control of medication expenses and by enforcing “gag” orders on pharmacists to prevent them from allowing patients to purchase medications cheaper.

5. Paying for their ever-expanding buildings and remodeling projects to upgrade the “playgrounds” (offices, spas, gyms, etc.) of their executives, at least when they are there, because they’re usually at the golf club, yacht club, flying off in their private jets, etc.

6. Note where the employees fall. Here.

7. Note where the client (the patient) falls. Here. Sad. Because guess who is paying for ALL of the above? The patients! And to top it off, Obamacare just added (by laws requiring citizens to have such health insurance) more and more of these paying clients, yet the “guarantees” that your benefits wouldn’t change, DID NOT materialize. Everyone I know that has insurance is paying MORE for LESS.

I have heard that many more medical offices are refusing to complete Prior Authorizations for their own patients, due to the time and hassles it creates.

Now I just got my first pharmacy form from a Douglas County pharmacy that has the following paragraph:

“Please indicate the status of this Prior Authorization (PA) request:

____ PA has been granted for this prescription.

____ This office DOES NOT perform PA requests (bold is my emphasis)

____ Please fill the prescription WITHOUT insurance.”

That’s basically what it has come down to. Waste lots of time dealing with insurance company and PBM slaves who change their spiel almost weekly and send you the wrong forms to waste even more time.

It has now become more efficient to just say NO and make the patient pay even more money for the prescriptions that the doctors could care less how much it costs; afterall, you have insurance!

You Might Also Enjoy...