Re: Re: prior authorization abuse of US

[Guest guest]

Have the patient call your state insurance commissioner/auditor- whatever they are called in your state. The only reason they could require a pre auth is to push the patient into purchasing on their own. Unless they have decided to micromanage all clinical decisions re: drugs. I would go through with the authorization process in order to determine what their criteria for approval or disapproval is- and use that against them any way I could.Does anyone's contract with a company spell out that it is required that we do pre-auths?Carla

To: Sent: Thursday, March 22, 2012 6:23 AM Subject: Re: prior authorization abuse of US

even the 9.99 they're shortchanging the patients. but im spending however much my hour is worth to click, look, read, scratch my head, cuss, x the fax out, do jumping jacks to get the bad energy out of me, call the patient, hear them cuss and explain to them why they have to pay out of pocket for something theyve been on for longer than ive been born.

i am a member of the acp. is there a CEO counterpart of that type like kathy mentions?

g for geesus..

>

> That is insane.

>

>

>

> You can get Metformin for $9.99 for 3 months on most generic drug plans.

> Tell you patient to just go buy it and to H-E-double toothpicks with the

> prior auth. In this case, you don't have to play the game.

>

>

>

> But if you are a member of the AAFP, send this to your CEO of your state

> chapter as an example of abuse. Often they are talking and working with the

> insurance companies with complaints. They can also bring it national in

> conversation with the PCPPC or whatever the initials are as examples of

> unfriendliness to PCP that make our jobs difficult and do not improve care.

>

>

>

>

>

> Kathy Saradarian, MD

>

> Branchville, NJ

>

> www.qualityfamilypractice.com

>

> Solo 4/03, Practicing since 9/90

>

> Practice Partner 5/03

>

> Low staffing

>

>

>

>

>

>

>

> From:

> [mailto: ] On Behalf Of pricklyfinger2007

> Sent: Wednesday, March 21, 2012 10:22 PM

> To:

> Subject: prior authorization abuse of US

>

>

>

>

>

> so i found out today that i have to prior authorize generic metformin for a

> diabetic.

>

> is there any government/ ACP of AAFP committee i can report these insurance

> company to for wasting my time. is metformin not supposed to be used on a

> diabetic anymore. is it still 2012?

>

> grace

>

[Guest guest]

I think that's a $4 drug at target and Ralph grocerSent from my iPhone

like seriously?

waste of paper and time for me to read these stupid things.

i think i should be able to report them for these things but to whom?who do they answer to?

i was ready to strangle somebody and cussing in a foreign language doesnt really make a difference it just sounds like some form of exotic food.

g for geez

> >

> > so i found out today that i have to prior authorize generic metformin for a diabetic.

> >

> > is there any government/ ACP of AAFP committee i can report these insurance company to for wasting my time. is metformin not supposed to be used on a diabetic anymore. is it still 2012?

> >

> > grace

> >

>

[Guest guest]

I almost have to wonder if the prior auth is required for something like this precisely because it is widely available as a $4 drug.  Why? Well,  I’m guessing that some pharmacies probably charge the insurance companies substantially more than 4 bucks; by creating inane/painful preauth requirements, insurance companies will likely encourage many physicians and patients to just seek the cheaper outlets and not involve insurance at all.  On a drug as  widely prescribed as metformin, that could potentially add up to beaucoup bucks. From: [mailto: ] On Behalf Of Sent: Thursday, March 22, 2012 4:01 PMTo: Subject: Re: Re: prior authorization abuse of US I think that's a $4 drug at target and Ralph grocerSent from my iPhone like seriously?waste of paper and time for me to read these stupid things.i think i should be able to report them for these things but to whom?who do they answer to?i was ready to strangle somebody and cussing in a foreign language doesnt really make a difference it just sounds like some form of exotic food.g for geez> >> > so i found out today that i have to prior authorize generic metformin for a diabetic.> > > > is there any government/ ACP of AAFP committee i can report these insurance company to for wasting my time. is metformin not supposed to be used on a diabetic anymore. is it still 2012?> > > > grace> >>

[Guest guest]

I just had to take a patient off Nifedipine and put on Diltiazam for same prior auth stupidity. It's so ridiculous. If there is a place to complain to let me know. I'm in. To: Sent: Friday, March 23, 2012 12:07 AM Subject: RE: Re: prior authorization abuse of US

I almost have to wonder if the prior auth is required for something like this precisely because it is widely available as a $4 drug. Why? Well, I’m guessing that some pharmacies probably charge the insurance companies substantially more than 4 bucks; by creating inane/painful preauth requirements, insurance companies will likely encourage many physicians and patients to just seek the cheaper outlets and not involve insurance at all. On a drug as widely prescribed as metformin, that could potentially add up to beaucoup bucks. From: [mailto: ] On Behalf Of Sent: Thursday, March 22, 2012 4:01 PMTo: Subject: Re: Re: prior authorization abuse of US I think that's a $4 drug at target and Ralph grocerSent from my iPhoneOn Mar 21, 2012, at 9:33 PM, "pricklyfinger2007"

wrote: like seriously?waste of paper and time for me to read these stupid things.i think i should be able to report them for these things but to whom?who do they answer to?i was ready to strangle somebody and cussing in a foreign language doesnt really make a difference it just sounds like some form of exotic food.g for geez> >> > so i found out today that i have to prior authorize generic metformin for a diabetic.> > > > is there any government/ ACP of AAFP committee i can report these insurance company to for wasting my time. is metformin not supposed to be used on a diabetic anymore. is it still 2012?> > > > grace> >>

[Guest guest]

Depending on your state, it's under department of health, apparently they respond faster if they get multiple complains on a given issue. Eg:

NYS DOHNYS Insurance DepartmentInsurance Superintendent Good luck. Frances Ilozue, MD Rapha Family Medicine, PC2200 Main StreetBuffalo NY 14214716 2004825 fax To: Sent: Friday, March 23, 2012 12:16 PM Subject: Re: prior authorization abuse of US

now how can anyone (in government) NOT SEE

that the problem is NOT how we charge a whopping $52 a visit

NOT how "poorly" we utilize health care

NOT how patients "abuse" the system

but THE INSURANCE COMPANIES are taking us all to the cleaners

while the United health care CEO is drinking a frozen margarita in the Bali on our dime

all because they dont want to spend $4/month for the patient who spends $600 / month for premiums.

g for g.crickets!

(a frozen margarita really sounds good now that i mention it)

> >> >

> >> > so i found out today that i have to prior authorize generic metformin for a diabetic.

> >> >

> >> > is there any government/ ACP of AAFP committee i can report these insurance company to for wasting my time. is metformin not supposed to be used on a diabetic anymore. is it still 2012?

> >> >

> >> > grace

> >> >

> >>

>