I know insurance companies are employing certain diabetes, programs, and programs for the management of obesity. I have not had the experience of having a patient call to say they were asked by the insurance company to stop a medicine.
What exactly are the rules surrounding what insurance companies are allowed to do? This seems way out of bounds for an insurance company.
#endocrinology #diabetes #type2diabetes #healthinsurance #endocrinologist
a month agoshayokay7
You may want to ask the patient to clarify what correspondence she received from the insurance and review the documents yourself. Insurance usually doesn’t provide medical advice. In some cases, they may only tell the member what’s covered under the formulary or whether prior authorization is required especially if a medication isn’t on the formulary. But they don’t offer medical guidance.
2 months agowingsgal60
Did they suggest an alternate ? Was it a case manager, who is often an RN of NP ?
2 months agomadden_js
They may have asked her to try a similar med. Other than that, is the insurance company from her employment-maybe they don’t cover that medication-why aren’t you calling the insurance company. Maybe she doesn’t quite understand what they are asking.
2 months agosassermaureen
I think medical professionals should raise holy hell with these insurance companies
2 months agoannechome
United Healthcare denied my newly prescribed BP medication, I called Optum (UHC’s pharmacy division), and asked the rep if she was a medical doctor who could override my physician’s diagnosis and prescription. She said she was not an MD and then agreed to allow the prescription to proceed. What a waste of multiple people’s time.
2 months agod.morrison.johnston
Insurance companies... Pharmacies... they all want to "play doctor" without actually being licensed to practice medicine. Trying to over-ride medication a doctor has prescribed seems to be one of their fondest past-times. It needs to be made illegal.
More posts
