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To: Lockbox
I love this, insurance company determines if “your medication is medically necessary”.

You should, because the group of doctors reviewing it have more medical knowledge in their little finger than your family doctor. And, don't think they don't know your entire medical history, because they do. So yeah, it's a good thing.

It's to the insurance companies' benefit that you receive the best treatment for your condition. It costs them less if you don't end up in intensive care because some doctor in a rush prescribed you some ineffective or wrong meds. For example, in the case of Humana, they contract out the med referral review service to an independent group of medical EXPERTS in their specific fields. If they find a disagreement between what they think and what your doctor thinks, they will call and conference with your doctor to give him the opportunity to explain his path and method of treatment if you have a unique case. It's usually a 24-48 hour turnaround.

If you are having trouble getting a prescription filled, it's likely because your doctor is dragging his feet explaining himself as to why he prescribed a non-standard treatment. It's Humana's policy to abide by whatever the independent expert panel recommends, no matter the cost of treatment.

53 posted on 11/27/2021 5:58:44 AM PST by eastexsteve
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To: eastexsteve
There is the in person exam requirement under the Ryan Haight Act for Controlled Substances which could come into play. Next the Medical Director for insurance companies are more a figure head who looks out for the bottom line of an insurance company. Lastly I have supplied personnel to some of the largest health insurance companies. I love how they have high school graduates denying treatment authorization to Doctors.

So bottom line, health insurance companies are not your friend and don’t have your best interest in mind.

54 posted on 11/27/2021 6:44:40 AM PST by Lockbox (politicians, they all seemed like game show hosts to me.... Sting)
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To: eastexsteve
It's Humana's policy to abide by whatever the independent expert panel recommends, no matter the cost of treatment.

And somehow PPB always manage to chose the one that is the cheapest and does not work.

Humana is undoubtedly the worst health insurance in the country. Killing more people per year then anyone besides Baby Killers Incorporate.

67 posted on 11/29/2021 9:06:26 AM PST by Harmless Teddy Bear (add a dab of lavender in milk, leave town with an orange and pretend you're laughing with it)
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