Many patients are unaware of the surgery authorization process. Rebecca Thompson here at Prairie Spine goes over why this process can be a very timely manner. Read the article below for more information and see how our staff does their best to keep patients updated and aware of these authorizations. If you have any questions or to schedule an appointment please contact us at 309-691-7774.
When a doctor tells the patient that it is time for surgery, they should be aware there is a process that still needs to take place. For most insurance, there is a prior authorization process. This can sometimes be completed in one day, but with some insurances such as workman’s compensation, it can take months. This is not in any way our desire to stall you but must happen to make sure the surgery gets paid for and you are not left with a huge bill.
Sometimes we will get a denial and must get more testing or a second opinion, independent medical evaluation (IME), is required. This usually happens when the insurance company doesn’t feel like we have met their pre-determined criteria for that particular surgery. On some occasions, our providers can do a “peer to peer” and speak with a doctor employed by the insurance company and explain special circumstances that would then make the patient qualify for the surgery without further testing.
The surgery authorization process can be a timely matter. Our staff does the best they can to keep patients aware of what is happening and continue to see patients while waiting on authorizations to try to keep them in as little pain as possible without creating post-operative issues. Sometimes our hands are tied with increasing medications or doing further injections before surgery to be able to properly manage pain after the surgery.
- If you are in the authorization phase of your surgery process, please keep a few things in mind:
- It can sometimes take time, and we are working to get it done the best we can.
- If we order more testing or send you for another appointment we were required to do so.
- We are here to help you, so we will move forward as quickly as the process allows.
- We are human, so calling to check in on things from time to time is not a bad thing if you haven’t heard from us.
