Wednesday, December 9, 2009

Peer to Peer Review Time

Turns out my insurance denied my out of network exception because they believe I can get DIEP stage II services in my town.

I invited the person who thinks this to come to my town, get that done and let me see it.

Of course they can't because there is NO doctor in this town who can do a DIEP. I pointed this out, but no one cared that such a simple and big mistake was screwing this up.

Insurance medical approvers are as invisible and untouchable as radiologists, it seems.

If this ever happens to you, the words you need to know are "peer to peer review." You need to have your doctor call the insurance's precertification office and request one of these.

Allegedly, this is much, much faster than the other option--appealling it myself. So it's back in my doctor's court.

I'll keep you posted.

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