The issue of doc-to-doc calls is something I’ve been writing about for over 20 years, including recently in an article about end-of-year unfair claims practices. Still, I’m getting phone calls from non-clients and clients telling me their physicians are speaking with insurance doctors.
This is something that, with only one exception, should never be happening. (The exception is CIGNA.) Although most treating physicians have backed off in recent years from taking insurance calls, there are always treating physicians who “think themselves capable of handling it” although the results are often devastating to their patients.
Let’s give insurers their due; they are very clever using bona fide interrogation techniques of persuasion and can easily convince any treating physician to agree with their agenda that patients can work. Basically, insurance docs intimidate treating physicians to the point that they feel unqualified and less credentialed.
Apparently, Unum is engaging in a priority focus to make doc-to-doc calls for year-end and they are successful in getting through. This is something insureds need to take care of right away. Although my clients are provided with additional options, my public recommendation is for insureds to update their HIPAA Authorizations in their doctor’s offices to say, “I DO NOT GIVE ANYONE FROM THIS OFFICE PERMISSION TO DISCUSS MY MEDICAL CONDITION WITH ANY REPRESENTATIVE FROM MY INSURANCE COMPANY.” This should also be discussed directly with your treating physicians so that they clearly understand you give “NO authorization to discuss your medical information electronically by phone.”
Physicians who go ahead and speak with insurers are then violating HIPAA and patients can file complaints. Insureds need to do this as a matter of self-advocacy for their own claims, but often wait until its too late.
DCS, Inc. has never trusted treating physicians who go against patients’ wishes and speak with insurance companies anyway. In nearly every incidence, it turns out that the treating physician “told” the insurance company something not previously shared with the patient. Something like….”…this patient can work.”
Please be aware that treating physicians are NOT required to speak with insurers on the phone and also have the right to request that all information given be requested in writing only. Then, insureds can insist they review responses before any medical information is faxed back to insurers.
This is important. This is essential. This is something you need to do right away. Most insurers are trying to financially make-up for COVID lost time by having a direct, verbal route to your treating physicians. Whether or not Unum, or any other insurance company speaks with your docto, is entirely up to you.