What you are saying is generally true. The only real oversight in ensuring things are moving forward is us ourselves as patients. It’s our responsibility as patients to take charge of our health.

That being said, P2P is sadly a standard aspect of American medical practice. Essentially anyone in a direct patient contact position position has done them. In the clinic or hospital, it may be your primary clinician handling it but it doesn’t necessarily have to be. It can be handled by other clinical staff or a group of nonclinical doctors also.

You dont have to worry about P2P since it will get taken care of (whether the service will be covered by insurance is another story). Instead I’d focus on keeping disconnected parts of the system abreast of your medical conditions and current list of medications. Because health information is protected there really isn’t a great solution for centralizing this data yet so if you go to a clinic that’s on a different EMR, they’re not going to have all of the necessary information available to them.

This is advice for doctors, not patients.

Usually doctors do the peer to peer and then the patient can appeal once services are denied (which is almost always the case if you’ve reached the peer to peer stage).

I’ve used this before with mild succees. It’s far from reliably effective. You’re more likely to get the decision over turned at the appeal stage, the problem being that precious time is lost while going through that process.

I do like to schedule an appointment so that patients are part of the peer to peer call. That way they can tell the doctor, nurse, PA, NP or whichever other service reimbursement bouncer the insurance company has hired that they’re putting a curse on them and their family.