why do I have to justify or rationalize using what I've been

[Guest guest]

I recently had both of my knees replaced. My surgeon had to justify

this surgery to my insurance company by pre-authorizing the surgery,

as well as the number of days spent in the hospital. Additionally

he had to justify the meds I was on so the insurance company would

not think they were paying for highly addictive drugs to some

addict, not simply for someone who was interested in short term pain

modulation.

I do know that mds are having to justify their care, but they have

the state of mind that this is just part of the business of

medicine/insurance. We have to accept that today, this is the way

we have to do business. As many of us remember when we started

practicing, we all wished that we could " get into the game " of

insurance re-imbursement. Well….now we are. And having to play by

their rules is part of that " game " .

Either do what the insurance companies want for payment, or start a

cash only practice. That is really an option, and you won't have to

justify your care to anyone but the patient. If the patient doesn't

like what you are doing, they can then go somewhere else. I may be

looking at this issue from a pragmatic and simplistic point of view,

but hey, we all have our opinions.

Grice, DC

Albany, OR