Many insurance companies are requiring an increasing number of prior authorizations and other cumbersome paperwork all for the sake of delaying and trying to get providers to change or eliminate medications or treatments that they don’t want to pay for; mainly because they’re too expensive. When they pay for care, they lose money. They want to keep as much of your insurance premium payments as they can, because once it’s their money, they really don’t care about your healthcare.
A recent American Medical Association survey showed over 90% of physicians are troubled by the increase in prior authorizations and that at least one person on their staff wastes almost a day’s work dealing with such issues. Over 25% reported that these delays have caused bad outcomes for patients waiting for their medications or treatments.
Our patients report that some providers and clinics in Douglas County are refusing to do prior authorizations due to the time involved. They don’t really care if you get your medications or not, they just don’t want to be bothered by it, because they can’t bill the insurance company and get repaid for their time doing that paperwork.
Dr. George chooses not to deal with insurance companies because they are not really interested in your healthcare, only your money. Their goal is to make your money, theirs. Insurance company contracts with medical providers are so one-sided and dictatorial in nature, that providers are basically “forced” into signing them in order to be able to “play” the game. Dr. George chooses not to “play” their games or bow down to their gag rules (limiting what treatments or medications can or can not be discussed with patients), hospital coverage policies (dealing with the local hospital is a joke), and more.
Health Net insurance recently denied a patient’s medication that they have been on for years. Their form states they want the patient to try and fail two medications: fentanyl patches and extended release oxymorphone. Oxymorphone has not been available on the market since the manufacturer withdrew it at the request of the FDA in 2018. How is anyone supposed to try something that’s NOT available? What type of idiots work at this company?
The VA system has instituted the MISSION program to get veterans medical care outside the VA due to their mismanagement and poor staffing. The VA system cannot even get their data right. Dr. George has been told that he is approved for the program by one entity, but then denied by another at the VA. Dr. George knows that he has not signed any agreements with the VA one way or the other. Too bad they don’t know what they are doing.