#Prior Auth | Explore Tumblr posts and blogs

drnic1 · 2 years ago

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The Healthcare Landscape: Challenges, Opportunities, and the Road Ahead in 2024

Each and every year there’s a rush for predictions for the coming year and 2024 is no different The Year of AI and Skynet Becoming Active The year Skynet/Mednet became active – not really but that was the fear with everyone calling it the Year of AI. For the rest of us, it was not so much the year of AI but rather the year that everyone else became aware of AI. Before we get into the…

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a2msolution · 2 years ago

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Payment Posting

To provide the #financial picture of medical practice by depicting the #insurancepayments in EOBs, including #patient #payments and #insurance checks from #ERAS.

Denials

To account for the count of #claims denial along with analyzing the causes behind such occurrences to undertake the necessary steps at the earliest.

Accounts Receivable

To follow-up the denied or rejected claims so as to reopen them with full evidence to receive 100% #reimbursements from the insurers.

Charge Posting

To make sure there will be no rejections after sending a claim to insurance to follow every guideline according to the Speciality. Correct use of modifiers updated ICD and billed amount , with accurate CPT.

Rejections

Some times numerous rejected claims get stuck in the clearing house, so we make sure to assign a professional who can fix all of them and send them to insurance.

Patient Collection

To have a dedicated professional who can do daily and regular followups on patient's due balance to collect their balances on your behalf.

Eligibility And Verification

To make time for your patients and the front office, we provide dedicated FTE to who can check eligibility and benefits before patients arrive for their appointment and also get authorization in advance for the procedures that need authorization.

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potsiefaerie · 6 months ago

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Dear Universe in general and anyone friendly and listening and capable in specific:

I would really really like it if the office worker who handles prior auths at my neuro's office could get to mine on Monday or Tuesday at the latest.

Thanks,

A migraineur who is sick of this shit

#I am two weeks late on my injection and they have not done the first prior auth #which will no doubt be rejected #and then they'll need to do the appeal #and in the meantime whenever the weather shifts my head fills with dense fog #so far the pain has mostly been minimal #except on Christmas #and I do still have enough of the rescue med for a while #but the last time I was off the injection for more than a month it didn't work as well anymore #and I'm terrified that's going to happen again #personal #migraines #healthcare system #deny defend depose etc #prior auths should not be A Thing #whining

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fathermulcahyofficial · 5 months ago

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I finally got my t gel packets 🎉🎉🎉

#yipppeeee #fucking finally #after being off of t for like 2 months going back and forth trying to get the stupid insurance and prior auth to go through #I’m basically back at the beginning because I was only on it for a month 😭#like pleeeeaaaassseee I’m not even gonna be on it long term I’m trying to achieve androgyny #testosterone #hrt #nonbinary

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lorelune · 6 months ago

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whenever anyone takes The Expensive Migraine Onset Medication™️ i am shaking hands with them. we’re in hell together.

#if u know u know LOL #(its nurtec)#unfort its such a new drug and an entirely new CLASS of drug so it is so goddamn expensive it’s insane #monthly supply is like… 1k at least? if not more #and u need a prior with for it and for that prior auth to be approved u gotta try and fail to take several drugs from a different class #my insurance covers it and i Pa NOTHING for it and it’s one of the reasons i won’t leave my company #lore loops

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ebonyheartnet · 3 days ago

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I fucking hate migraines.

I fucking HATE trigeminal neuralgia.

The shit knocked me out for four hours, and the stupid brain fog made me panic about missing one of my weekly games.

It’s a Friday game, and today’s fucking Tuesday. 🤦🏽

#chronic health tag #migraines #trigeminal neuralgia #someone help me hunt my neurologist for sport. I don’t think he ever did the fucking prior auth.

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exeggcute · 10 months ago

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sorry to be that guy on posts but I'm in an especially Thank You Modern Medicine mood right now because I'm counting down the hours to my own infliximab infusion tomorrow. save me 7.5mg/kg...

#I also recently learned the thing about using it off-label for graft versus host disease while digging through prior auth guidelines #it's not an officially approved use afaict but blue cross blue shield says they'll pay for it (if you answer their riddles three)

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charmcoin · 5 months ago

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i'm so fucking annoyeddddd man

#pers #prior auth for this prescription still has not been put in its been like a week and a half. I'll shoot myself in front of you

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pyjamaenzel · 8 months ago

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its been 2 months unmedicated...looking forward to feeling like a human being again

#enzel.txt #finally got to pick one up and the other is stuck in prior auth limbo #which i didn't find out til YESTERDAY #bc of the shortages the pharmacy wasnt even bothering to tell me the auth didn't go thru #so i kept waiting and waiting...#doctor is on it he said it's literally some stupid computer system error #so hopefully he can sort it out soon

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4lbon · 5 months ago

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they dont think i need to take a blood sample for low dose so they're sending in the t prescription today 😭😭😭😭

#im sooooooooo happy #i still need to wait a day or two for prior auth but omgggggggg #he speaks #AND they're putting my name on a wait list to get top surgery !!!!!!

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daimonios · 5 months ago

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the last several months ive had such ridiculous problems filling my T gel prescription that im just going to switch to injections. im so tired of this

#last month i needed another prior auth even though its been less than a year and then the PA was DENIED. and i had to appeal it #this month the student health pharmacy was straight up unable to order it so i went to stupid walgreens #and they only gave me half a months worth even though i was like 'usually its 2 boxes are you sure this is right'#AND it was twice as much money at walgreens. for no reason #personal

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salsa-ishida · 6 months ago

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you're back!! it's been so long!! I missed you <3 <3

ahhhh I missed you too!! Life has been insistent on grinding me to a paste but we perservere

#life has been so so so hard <3 #i've never fully recovered from long covid so an average workday was leaving me absolutely drained #and on top of that i had an incident where i was trying to look into a prior auth for a patient #the kid was trans and cried on the phone because he was afraid his insurance wouldn't cover his testosterone now that trump had won #his doctor was at her wit's end because she had been assured on three separate occasions that the authorization was all set #so since it was literally a dead day at work anyway i spent about half an hour playing phone tag with the insurance #trying to find out what their mcfucking issue was #only to eventually be told they wouldn't speak to a representative from the pharmacy about it and that the prescriber had to make the call #so i did let the prescriber know and found a goodrx coupon that made the price like $20 #patient was thrilled and very grateful for the effort #(this was like. the day before christmas and his last chance to get his medicine before he had to travel.)#pharmacist however immediately jumped my shit when i hung up for ''wasting time''#despite the fact that there was??? literally no other work to do???#we had three other techs on and i was keeping up with the data entry as things came in while i was on the phone.#tried to defuse the situation by apologizing but she was literally top-of-her-lungs screaming at me #in front of my coworkers and the like 2 customers nearby. so loud that one person could hear her clearly from the bathroom #had worked with this woman for 5+ years and she was the reason i went to this particular pharmacy in the first place #left and texted my boss what happened and told her that this gets fixed or i'm out. had a meeting with the store manager and everything #told them i would have a conversation with her to see if we could move past this. and she refused to speak to me #so i quit and my bestie quit in solidarity and we have been job hunting except that we both also got sick as FUCK the next day #like vomiting shaking massive headache unable to function sick #his fever was like 104.7 at one point? it was ungood #i'm finally about 85% better and back on the job hunt but like. yeah #thought i had something lined up that would free me from the shackles of customer service but unfortunately the guy changed his mind #and the one pharmacy interview i had they wanted to pay me $10/hr 💀 homie that's a $9/hr pay decrease #so yeah life is a prison etc etc BUT not having a full time job anymore DOES mean #that i have the time and energy to tungl again without all the chronic exhaustion #silver linings!!!

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bunnyb34r · 6 months ago

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🙃 I didn't ask for refills at my allergist appt last month bc I thought "oh I have 6 refills left, I'm good!"

... ya they were expired??? Fuckers?? How?? I thought they updated the script and that that's why I had 6 more refills??

Yeah apparently not 🙃 yay...

#marquilla #and it's Sunday so my pharmacy nor my drs are there til tomorrow then i have to hope that my insurance accepts them #wo the prior auth bullshit (bro dont question my drs decisions bitch) and then the soonest ill get them is Friday when im back at work #assuming theyre not ready Tuesday 😭#lets hope i dont get vertigo bc i will be livid if i get that for Christmas stsgdddgdg like have i not suffered enough?#im in a suffering contest and my opponent is christ himself apparently GSDGDGGDGD

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micamicster · 7 months ago

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Can everyone prayer circle to the patron saint of discharges today I need these children to go the fuck home!!!!

#prior auth go through. supplies get delivered. no fevers no nausea no iv pain medication i beg #go homeeeee

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mieczyhale · 1 year ago

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if we can't figure this shit out, like some financial alternative, i might have to make a fucking gofundme to get the psychiatric stay i need

insurance: covers everything but the kitchen sink; the kitchen sink being the most expensive necessity

of fucking course

#they said they'd cover it with a prior auth. and now apparently they've said they won't and i'm about 2 seconds from screaming and crying #maison speaks

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x-raykinks · 10 months ago

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I wish I could make one of those people who review prior authorizations on the insurance side kiss my boot and get real pathetic with it while my team of doctors watch.

#i really hate getting prior auths #this is between my and my doctor you sick fucks

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