All too often patients are told that a needed treatment is not covered by their insurance. For most patients who are working along, there is no way past this barrier. However, for our clients there is still hope. We have supported doctors to rewrite successful prior authorization requests and appeal denials for increased coverage.
Through a variety of creative strategies we support our clients to have the best chance of getting their medical needs covered.
Here are some examples of treatments we can help get covered:
One client was struggling to get an inpatient plasma exchange to treat her autoimmune disorder. With excellent communication between five different care entities, we accomplished a clean prior authorization and the patient received her treatment.
Another client was denied payment for home saline infusions to treat her postural orthostatic tachycardia syndrome. Although her Medicare insurance will not cover this, we applied for financial assistance through the infusion agency and her infusions are now covered at 100%.