So, I don’t have a lot of background on this, but supposedly some doctors have engineered approvals by asking the insurance company from a signed statement by a doctor on the refusal letter.
It’s a legal thing to request so that the clinician can avoid malpractice suits, when asked by lawyers why they waited to conduct an MRI.
Then, when the insurance company searches their staff for a doctor that will sign such a statement, they may quickly realize none of the doctors on their staff want to risk being sued for malpractice by signing such idiocy.
So, I don’t have a lot of background on this, but supposedly some doctors have engineered approvals by asking the insurance company from a signed statement by a doctor on the refusal letter.
It’s a legal thing to request so that the clinician can avoid malpractice suits, when asked by lawyers why they waited to conduct an MRI.
Then, when the insurance company searches their staff for a doctor that will sign such a statement, they may quickly realize none of the doctors on their staff want to risk being sued for malpractice by signing such idiocy.
Aetna gets around that by outsourcing the denials:
https://www.propublica.org/article/evicore-health-insurance-denials-cigna-unitedhealthcare-aetna-prior-authorizations