Patients and Physicians Speak Out

As a nurse I would spend 30 minutes or more on prior authorizations. The insurance companies would expect doctors to do these calls!  I would often call the insurance company to speak to a prior auth agent who obviously was not medically trained. They could not even correctly pronounce the medication name! They had no idea what the drug was for. They were just working off an algorithm. Try telling them a complicated reason why this patient must have this med...not gonna happen. In my opinion, this is all a way to prevent patients from getting drugs they need. Basically, some uneducated prior auth agent gets to nix a physician order!!!

I’m an RN in CA and recently resigned from my last job as a case manager because I was fed up with how health plans rob their members from needed services by very defined tactics to deny prior authorizations. 7 years of watching three insurances do this is so sickening!!!

I work in oncology, account receivables and prior authorization. It is heinous work. Treatment is OFTEN delayed while waiting for prior authorization. Honestly... why the eff do you need prior authorization for CHEMOTHERAPY? It's not elective!

I am one case out of hundreds that my surgeon has to spend hours upon hours needlessly playing phone tag and writing petitions for his patients so he can provide the care he wants. Outrageous. Exhausting the client and the doctor while keeping our premiums.