Just so tired of almost every time a doctor submits stuff to insurance, we have to be the ones to make multiple phone calls to both the doctor’s office and insurance to iron everything out, figure out what the issue is (it’s always a different issue), and basically be the go-between for the office and insurance. What am I paying $500+/month for?! It’s like paying for the privilege of having an exhausting part-time job.
And yes, I understand that insurance wants to weasel out of paying anything, but this isn’t even shadiness, just straight up incompetence and lack of communication/following procedures. The amount of emotional energy we have to spend untangling this stuff leaves us drained.
My favorite is pre-authorization.
I need a pre-auth before my insurance will cover the Adderall for my ADHD. Every year I must renew this pre-auth or I will not get covered for my prescription.
What is a pre-auth, exactly? It’s a Dr. Promising that yes, this medicine they prescribed is medically necessary. No, prescription alone does not count. Yes, it can come from the same Dr. who prescribed it.
And yes, I have to do it yearly to “ensure it’s still medically necessary” because my ADHD could magically go away one day, apparently