Well, I guess I’m sort of creating a series about insurance company insanity. I didn’t start out meaning to do it, but so many opportunities keep presenting themselves! Here’s a new one. One of my patients needed to get a specific type of stress test. Of course, I can’t just order it. No. It has to be approved by her insurance company, via a middleman company that runs their approval process. So, first we call them for approval. Then we send a copy of my office notes. Then, without fail, this happens.
This message says that my office notes that I sent them don’t meet their clinical guidelines for approval. I need to call them and talk to the physician reviewer to plead my case. Note that the message was received at 4:45 PM. Convenient. I was not able to return the call that business day. A good thing, too, since the next morning first thing off the fax, is this:
A notice saying they’ve approved the stress test, even though about 12 hours before they had denied it. I never called them. So, what happened between 4:45 PM on April 23 and 8 AM on April 24? I have no idea. Nor do I wish to look a gift horse in the mouth. However, the best part of that approval fax is that right after we got it, we got this: