With the return of egregious claims practices comes aggressive insurance physicians who are hired by insurers and the insurance industry to conjure written back-up to support claims denials. The philosophy of “do no harm” quickly turns into “do as much harm as you can” and thousands of insureds and claimants will have denied claims before year-end.
Basically, all insurance physicians who can’t practice anymore wind up harassing all those who can. Let’s not underestimate the intimidation effect insurance physicians can have on treating physicians, and if left to their own insurance agenda, can cause a great deal of harm to insureds.
When contacted by an insurance doctor your physicians will most likely react in several ways: 1) ignore the request to speak with an insurance doc on the phone, 2) take the call to quickly get rid of the problem, 3) ask for all communications in writing, and 4) reject the patient because their claim has become too “involved.”
Anytime a treating physician does NOT respond to an insurance company, the presumption is that the physician agrees with the insurance company that his/her patient can work.Therefore, the treating physician must respond in some way. Second, yes, there are treating physicians out there who will take calls from insurers to get rid of the problem quickly. Even when their patients refuse to give permission to speak with insurance docs, unfortunately physicians will take the calls. And, physicians already spend a great deal of time on filling out paperwork, so they don’t want to spend anymore time with patients who “cause problems.”
Unfortunately, some treating physicians just have to “grow a pair.” I apologize if I offend anyone, but it’s true. Wouldn’t it be great if your physician would just send a fax saying, “I am this patient’s treating physician and I see her in my office up close and personal every two months. It is my opinion that she is totally disabled and unable to return to any sustainable or consistent work.” Treating physicians should also say, “And by the way, here is an invoice for $200, which is my fee for filling out paperwork for narratives when you continually request them.”
I guarantee repetitive and frequent requests for information directly to your doctor would cease if your doctor started billing $200 for each request.I have always found that treating physicians are reluctant to bill insurance companies, although I’m not sure why not. But, they should. Hitting insurers in their pocket books can cure a great deal of egregious activity, and solves the problem quickly.
It is a best practice not to give your physician permission to speak on the phone with insurance docs. Some physicians regard doing this as a HIPAA violation, as in. “electronic communication of health data”. Just make sure your doctor knows what your intentions are, and be aware that the hungry vultures are out there waiting to “get to” your treating physicians.
