Healthcare providers and insurance companies are in a persistent game of cat and mouse.
We try to prescribe something that's gonna help a patient — and the insurance company denies it.
Today we had someone in our office training our medical assistants on how to better get drugs covered for our patients.
What we learned: Insurance companies are now starting to deny medications if we don't put the exact language from the prescriber's information label into the medical note.
A lot of times, they're saying we need to use medicines that are much older, with way more side effects. Or they're teaching us to use a medicine that's not even indicated for the patient's condition.
It's a persistent game of cat and mouse. We have to figure out what they want us to say to get the right drug for a patient — and they're always trying to figure out how to deny it.
This is the illness industrial complex. And it's why healthcare feels broken.
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