Who should start the insurance pre-certification process for the Uterine Artery Embolization medical procedure? 

“Unless a woman’s insurance company has rules that state otherwise, it should be the responsibility of the Interventional Radiologist to obtain ALL insurance pre-certifications and clearances, and to assist with any or ALL appeals.   

This is not the task of the referring gynecologist, not the task of the primary care physician, and not the task of the patient.  I actively discourage patients from calling their insurance companies to check on or obtain clearances, since this requires some expertise in negotiating the system.  My staff has this expertise.  In many cases well-intentioned patients have tried to check things out for themselves and have unwittingly caused significant confusion and difficulties with their pre-certifications.” – Dr. Worthington-Kirsch, Interventional Radiologist

Are you experiencing any problems with women getting medical procedures paid for by their insurance because they don’t want to have a hysterectomy? 

“No problem getting ‘paid’.  But many are paid at absurdly low rates, so no doctor could afford to do them if they are contracted.  I had to make a decision a few years ago to either stop offering hysterectomy alternatives, or to drop contracts with all insurance companies.  Since dropping contracts, patients cover what the insurance company doesn’t, and I can still offer alternatives.” – Dr. Indman, Gynecologist 

NOTE:  "Women need to know that because insurance may not cover a procedure fully it doesn't mean they can't have it done.  Most physicians and hospitals are willing to discuss arrangements for patients who have to pay their own way." - Dr. Indman and Dr. Worthington-Kirsch

 

 Appeal Section | Personal Appeal Letter
 Health Insurance by States
Self-Funded Insurance Policy and State 'Health Care Unit' Complaint Forms