Deny, Deny, Deny
So you have finally gotten a firm diagnosis, feel confident with the surgeons performing your procedure and the doctor’s office requests authorization for the procedure. After patiently waiting to hear back from the doctor’s staff you find out that the procedure has not been authorized. You have the doctor’s office appeal the decision and continue to wait. Sound familiar? It seems as though it does not matter if you were hurt at work, involved in a car accident or just got sick, it is a hassle to get your medical procedures authorized. In some cases, procedure authorization can take months to obtain and may never get authorized.
Ever wonder why this happens? Patients pay in some manner for insurance and yet difficulties arise when trying to get care authorized. Additionally, even if the care is authorized in many instances it is not guaranteed that the doctor’s bill will be paid in full. What does one do as a patient? We need the care, have the coverage, yet the insurance carriers often give us as patients a lot of difficulty in multiple ways some of which are described above. Why do the insurance carriers, after they obtain a file review or an IME(independent medical exam) deny, deny, deny the care? Why agitate the members of the plan? What could be the only reasonable explanation? I think we all know what it is. It is time that we as patients become educated regarding treatment authorization, bills not covered by the carrier for whatever reason so that we can fight for the care we justly deserve.
Such patient education will become more and more available as we continue to build the PatientReaction platform. Become empowered by discussing these important issues with other members of the platform with your exact condition and in many instances the same insurance carrier. Find out from other patients/caregivers that went before you who obtained the care they needed in a timely fashion and if it was covered in full. Don't settle for anything less. It's you or your loved one’s health that is on the line and there is nothing more important.
You’ve made it this far—now it’s your turn.
PatientReaction isn’t just in beta—it’s the start of a movement born from real struggle, real hope, and the voices of people who refuse to be ignored. This platform was built for you—for patients, caregivers, and survivors who’ve lived through what others are just beginning to face. If this blog resonated with you, don’t scroll away in silence. Post. Share. Speak. Your experience could be the insight, the comfort, or the encouragement someone else needs as they navigate their own journey—always in partnership with their healthcare team.
This is your space. This is our moment. Speak up—someone out there needs to hear you.