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.

  • gamermanh@lemmy.dbzer0.com
    link
    fedilink
    English
    arrow-up
    40
    ·
    7 months ago

    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

      • gamermanh@lemmy.dbzer0.com
        link
        fedilink
        English
        arrow-up
        13
        ·
        7 months ago

        Oh I know, I had a family member make the joke about suddenly regrowing a limb

        It’s disgusting and absolutely should result in anyone who’s ever approved that being put against the wall for their pure evil

      • s_s@lemm.ee
        link
        fedilink
        English
        arrow-up
        5
        ·
        edit-2
        7 months ago

        Any hassle they can create to manufacture a reason to deny coverage.

        It’s not “beyond belief” it’s disgustingly evil.

    • uis@lemm.ee
      link
      fedilink
      English
      arrow-up
      10
      ·
      7 months ago

      Wow. This is similar to what disabled people have to deal with in Russia. Like arm will grow back.

    • AlecSadler@sh.itjust.works
      link
      fedilink
      English
      arrow-up
      6
      ·
      7 months ago

      I have to do it quarterly for some reason. Annually would be…better, but still stupid. My doctor even thinks it’s dumb, so he usually just asks me all the rote questions…

      …no he doesn’t, he usually goes blahblahblah you’ve been doing this for 10+ years we know the routine. Unfortunately I still have to make an appointment, have an appointment, pay the deductible for said appointment, just to get 3mos of a medication that, thus far, I have a medical need for.

    • Sam_Bass@lemmy.world
      link
      fedilink
      English
      arrow-up
      4
      ·
      7 months ago

      It means they have to compare your request to a list of allowances that change annually at the whim of Corporate