Precertification, denials and appeals
Fam Pract Manag. 2006 Sep;13(8):16-24.
Thank you for Dr. Anthony Akosa’s article “Precertification, Denials and Appeals: Reducing the Hassles” [June 2006]. It described how to manage insurance company red tape. The real issue, however, is why do we deal with any of it? Ending insurance contracts and dealing only with patient reimbursement is the only way to permanently end the hassles.
Insurance companies created managed care to increase their profit margins. They have succeeded. They deny care to patients who need it and create more work and overhead for physicians. It is unbelievable that physicians and patients have allowed this to happen.
Pay for performance (see the special section in the July/August 2006 issue of FPM) is another manufactured absurdity that no other profession or workplace would tolerate. This emperor has no clothes either!
As physicians, we are supposed to work for patients only, not insurance conglomerates who work for CEOs and stockholders.
WE WANT TO HEAR FROM YOU
Send your comments to firstname.lastname@example.org. Submission of a letter will be construed as granting AAFP permission to publish the letter in any of its publications in any form. We cannot respond to all letters we receive. Those chosen for publication will be edited for length and style.
Copyright © 2006 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions
More in FPM
Related Topic Searches
MOST RECENT ISSUE
Access the latest issue
of FPM journal
The Adolescent Health Consortium Project has clarified clinical preventive service recommendations for adolescents and young adults.
Here's how to succeed in the four performance categories of the Merit-based Incentive Payment System.