[golfing eagles]

Originally Posted by JMintzer

Doc,

Like you, I was in practice (I still am, albeit part time) for almost 40 years...

But I'm going to have to disagree with you on this one. If it were a simple "coding error", then the non-advantage plans would also deny the care (which they don't).

We call to get pre-authorization all of the time. They pre-authorize the care, then they deny payment, stating the pre-authorization was never actually a promise to pay.

Now, granted, we've also occasionally had that happen with commercial insurance companies, but it much, much more rare...

You haven't had care denied by straight Medicare, supplements, and private insurance????? OMG are you lucky. We had 5 FTEs dealing with all those problems---fighting denials cost us over 1/4 million/year-----which is a fraction of what it cost the government to create those denials in the first place. A vicious circle with no winners.