Oo Oo I just discovered this reddit!!
I work in a health insurance call center. They actually take pretty good care of us and most of the time I love my job!
I got a call today from a person who’s doctor just told them the prior auth for their surgery (on Monday in a week) wasn’t approved. Doctor had just sent in the pa request last week. It was denied because criteria not met basically. So I read the notes to the lady. She goes off on me.
Lady:Why are you denying this!!! We have been planning this since October!! I need this surgery and I’m having it on Monday!!
Me: 🤷♀️ if you’ve been planning this since October your doctor should have sent in the prior authorization request months ago. They can appeal the decision and request an appeal but those can take up to 30 days and requests for urgent aren’t granted for scheduling reasons. Our policy is that urgent requests have to be life or limb threatening.
Lady: this is such bullshit!! You are ruining my life!!! hangs up
Me to coworkers around me: guys! I ruined someone’s life! I’m so upset! /s
Like really at this point I love doctors but I’m tired of their staff blaming insurance for denying things they didn’t have the foresight to do. Like send in your prior auths more than a day in advance. Yay us healthcare 🙄