
- If you find yourself uninsured or underinsured, try applying for financial assistance through your medical facility’s billing or financial hardship department. You may be eligible to apply even before you have your procedure.
- One thing you can do to minimize the risk of insurance denial is to call your insurance company before scheduling your procedure to confirm if it is covered or not. If not, you can consult with your doctor for alternative options before exerting the time, money and preparation for surgery only to have it canceled at the last minute. You can also work with your specialist to schedule your surgery far enough in advance to allow for the latency caused by the appeal process, although timelines for the appeal process may vary.
- If your doctor refuses to move forward with your desired treatment plan or tries to pressure you into an option that you are not comfortable with, be sure to obtain written documentation for your patient file that your request was denied and why. This is important. Although it is often easier said than done, this is a circumstance under which you should fire your doctor and seek out a specialist who is willing to work with you in a collaborative way rather than an unproductive one.
- One way to protect the integrity of your prescribed medications is to have your doctor submit a prior authorization form, indicating that you have tried other medications without success, and that your currently prescribed medication is the best option for treating your condition at this time. If necessary, have doctors specify that no generic substitutions are to be made. Prior authorization forms are submitted by your doctor directly to your insurance provider. Most need to be renewed annually, and some insurance providers will mail you, not the doctor, notifications a few months before the authorization is set to expire. I strongly recommend keeping personal documentation of the medication name, prescribing doctor and date of authorization and expiration and reach out to your doctor to remind them to renew the authorization between 30 and 60 days before expiration.