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Prior Authorization: Scrooged

Editor’s Note: On March 17, April 2, June 23 and Oct. 12, Past President Cindy Firkins Smith, MD, detailed her and her patient’s frustrations with the current medication prior authorization process. She thought it had ended in October…

When I last wrote, I was celebrating my patient’s victory. The Medicare Administrative Law Judge (ALJ) had ruled in his favor; Medicare Part D and his Blue Cross Blue Shield supplement was required to cover his mycophenolate mofetil (MMF). I believed that my patient’s battle was over. I was wrong.

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Tuesday, December 22, 2015/Author: Cindy Firkins Smith, M.D./Number of views (228)/Comments (0)/
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Four transfers and 23 minutes later (The end)

Editor’s Note: On March 17, April 2 and June 23, Past President Cindy Firkins Smith, MD, detailed her and her patient’s frustrations with the current medication prior authorization process. Here’s the end of the 10-month saga.

We won!  But did we?

If you’ve read the first three installments of the story of my cicatricial pemphigoid (CP) patient’s prior authorization (PA) struggle, you know that in January of this year Mr. F changed Medicare supplemental insurance plans and was subsequently informed that the mycophenolate mofetil (MMF) that had been controlling his debilitating immunobullous disease for three years was no longer covered. Thus, began our arduous journey of phone calls, letters and roadblocks.

For the entire article, click here

Monday, October 12, 2015/Author: Cindy Firkins Smith, M.D./Number of views (511)/Comments (0)/
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Four transfers and 23 minutes later (Part 3)

Editor’s Note: On March 17 and then again on April 20, Immediate Past President Cindy Firkins Smith, MD, detailed her and her patient’s frustrations with the current medication prior authorization process. Here’s an update.  

It’s nearly July and summer is full-blown. Life barrels ahead full steam. Not so, my patient’s prior authorization (PA) nightmare.

When I first wrote about my Ciciatricial Pemphigoid patient March 17 he had recently been denied his mycophenolate mofetil (MMF) and I was struggling through the confusing and frustrating process we call prior authorization. I haven't read Dante’s Inferno but having seen descriptions of his Circles of Hell I was sitting in the Fifth Circle: Anger.

For the entire article, click here.

 

Tuesday, June 23, 2015/Author: Cindy Firkins Smith, M.D./Number of views (731)/Comments (0)/
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3 Financial Tips for Young Physicians

Guest bloggers: Joel Greenwald, MD, CFP® and Mai S. Yang, CFP®

Residents, fellows and physicians early in practice have unique financial challenges. The good news is that if they make a few good decisions early on, they can significantly improve their chances of long-term financial success. Here are a few financial planning tips for young physicians.

1.    No one likes to think about bad things that might happen, like death or disability, but insurance protection is the foundation of any young physician’s financial plan.  

For the entire article, click here

 

Tuesday, June 16, 2015/Author: Author Guest/Number of views (1040)/Comments (0)/

Four transfers and 23 minutes later (Part 2)

Editor’s Note: On March 17, Immediate Past President Cindy Firkins Smith, MD, detailed her and her patient’s frustrations with the current medication prior authorization process. Here’s an update. 

Since I last wrote, my patient’s (and therefore my) Mycophenolate Mofetil (MMF) prior authorization (PA) woes continue. Since then…

For the entire article, click here.

Monday, April 20, 2015/Author: Author Guest/Number of views (1298)/Comments (0)/
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