Quote:
Originally Posted by dmek25
agreed. but what gives them the medical "expertise" to make those calls? pricing? the person making those decisions is about medically qualified as i am
|
Thats not true. Health Ins. Co. have on staff doctors that review whats been done and what the doctor is requesting. In most cases like my daughter if the her doctor can show why the plan B (the more expensive plan) is the best route to take then in most cases the ins. co. will allow them to skip plan A because in the long run it will save them money. If the doctor is lazy and just writes up a two sentence request then most of the time the Ins. co. will say no start with plan A.
I'm sure Sneed can give more details on this works. One thing to remember alot of people throw in to the mix expermental treatments which is tough to get the ins. co. to approve.