This is why I refuse to do peer to peer pre authorization calls. I’m actually trying to save the insurance company money by ordering out patient studies and prevent patient from going to the ER. If it needs a peer to peer, I just send them to the ER for the study. These money hungry insurance companies will never learn.
When I was in Family Practice, I would ,many times!!!!! call the insurance company for my patients to get preauthorization on a test they needed, only to be told NO. Then I would threaten them by saying ” I need your full name and social security number”. When the innsurance representative said, “My social security number??” I would say, “Yes, because this patient is going to die and we are going to end up in a law suit in about 5-10 years. You need to be on the witness stand testifying as to why you denied this request. I will be able to find you through your social security number.” The person then ALWAYS said, “YES. your request has just been approved”. It has nothing to do with medical records. It has to do with how many times insurance can deny coverage to keep from paying for a patient’s medical treatment.