I have been doing PAs for 4 years at our office. They ebb and flow as they come in. They come in from many resources/places. They are confusing at best. The insurance cherry picks their questions and some are ridiculous. Most require me to work through patient notes and decipher what drugs patients have tried/failed. This is one of the most consistent questions insurance asks. They are no closer to understanding what the patient has been through nor do they have the patient case notes at their disposal. There are also insurance companies that make it mandatory to submit case notes. It is a hard job and I have a feeling I will still be doing many hours per week of insurance talks because in many cases the insurance is expired, inaccurate coverage or has a problem with the tier of the drug. It will never be as easy as a push of a button, and our providers in our office leave all of it up to me along with the guilt I feel when a claim is denied!
😢 I'm going to start a job doing prior auths, it'll be my first time doing thus type of job. Is it as overwhelming as it sounds? Now I'm scared it'll be too confusing and hard for me
requiring prior authorization is a way to delay needed treatment, leave the patient with non-working substitute and potentially kill the helpless patient who does not get the treatment he needs while the administrators shuffle paper ... I went through this nightmare - and a very expensive one...
Don't forget that just because a doctor has written and sent a prescription to a pharmacy, it does not mean it is approved then and there. The insurance has the right to take up to 3 or 5 or 7 days to process, I believe they will hold to that. Some PA's take me 5 minutes, some take me 5 days...the ones that are problematic.
I have been doing PAs for 4 years at our office. They ebb and flow as they come in. They come in from many resources/places. They are confusing at best. The insurance cherry picks their questions and some are ridiculous. Most require me to work through patient notes and decipher what drugs patients have tried/failed. This is one of the most consistent questions insurance asks. They are no closer to understanding what the patient has been through nor do they have the patient case notes at their disposal. There are also insurance companies that make it mandatory to submit case notes. It is a hard job and I have a feeling I will still be doing many hours per week of insurance talks because in many cases the insurance is expired, inaccurate coverage or has a problem with the tier of the drug. It will never be as easy as a push of a button, and our providers in our office leave all of it up to me along with the guilt I feel when a claim is denied!
😢 I'm going to start a job doing prior auths, it'll be my first time doing thus type of job. Is it as overwhelming as it sounds? Now I'm scared it'll be too confusing and hard for me
requiring prior authorization is a way to delay needed treatment, leave the patient with non-working substitute and potentially kill the helpless patient who does not get the treatment he needs while the administrators shuffle paper ... I went through this nightmare - and a very expensive one...
Don't forget that just because a doctor has written and sent a prescription to a pharmacy, it does not mean it is approved then and there. The insurance has the right to take up to 3 or 5 or 7 days to process, I believe they will hold to that. Some PA's take me 5 minutes, some take me 5 days...the ones that are problematic.