Read the latest Medical Economics. There is an article there where an M.D. began prescribing more generics to assist with the financial burdens of her patients. Because they could get them cheaper at Wal-Mart than through their insurance drug program, that's where they went. Subsequently, these patients and their drugs did not show up on their insurance companies master lists and, when the companies looked then at the precribing habits of this particular doc, she was rated as being an over-prescriber of brand name drugs!! She was given a low-rating by the insurance company!! I see only problems such as this when we provide any information to the insurance companies which does not directly relate to their ability to pay a patient's claim. That's what they are for...to pay for the claim...not manage the medical care. I continue to play as hard-ball as I can with them. Last week I had a request from UHC for info regarding pre-existing disease in a patient. I completed the form but the number to which it was to be faxed was long-distance. There was a toll-free number to call for questions so I had one of the girls call them and tell them we would be happy to fax back the form when they provided us with a toll-free number. They have yet to do so and have requested the report 3 more times with us giving them the same response. We finally called the patient and told her she needed to pick up the form and either fax it herself or mail it to them but I was not going to pay even $.30 to complete their insurance company's ridiculous request. Granted, I spent a lot of employee time messing with this but it is a matter of principle. The patient picked it up yesterday and said she was calling the company to complain to them. Don't give 'em an inch.
Leslie
