Leslie,
I generally take the path of least resistance, and whatever keeps my nurse off the Preauth hotline and keep her productive is how I have been coerced into practicing just to maintain some level of efficiency. I don't like it but have learned this is what works best for me. I really feel frustrated most days and take solace in the song by Beck--"everyone is out to get you...".
It may have to do with being 3rd in pecking order growing up and learning at an early age that being dominated by my older brother in matters of confrontation was best handled by submitting to his will, and the quicker I learned this the better we both got along.
I am learning quickly this is the way of the electronic health record as well.
No easy answers.
However, about a month ago I got a similar denial on a diabetic with multiple strokes unable to take anything but welchol, and intolerant of statins, niacin, etc. I sent out 2 letters, a nice one via updox explaining rationally of my recommendation (knowing this would get denied) and a second via mail (letting the insurance company know I will be facilitating legal counsel for my patient when she has her next stroke off the welchol) In 3 days I got approval for a year--same scenario will need to be repeated in a year--and what a waste of valuable time for all parties involved. jimmie
