Here's a common "peer-to-peer" conversation I have repeatedly with the #insurance companies as an oncologist:
Me: I want to appeal your denial of my patient's PET scan
Them: Sorry, PET scan isn't on our approved list
Me: You approved it last time, and it's a standard-of-care that the patient have a repeat PET scan to assess if their treatment is working
Them: Oh, we approved it last time?
[much hemming and hawing while they verify this]
Me: By the way, are you a board-certified oncologist?
Them: [again much hemming and hawing, and only when I insist do they tell me their name and credentials (and about 95% of the time they aren't an oncologist)]
Me: Let me make sure I have the spelling of your name correct for the chart so I can make a note of who is denying the necessary medical care for my patient
Them: [Finds a way to approve the PET scan]
And scene
(many times a month)
#MedMastodon #healthcare #healthinsurance #healthcareisahumanright #cancer #oncology