Daily Docblock: Denied Edition


It seems the doc-blockage never stops. A particular thorn in my side has been Care Core. They manage imaging services for an insurance that we accept and often deny coverage for CT scans. Once the requested test is denied, the physician may appeal by calling a 1-800 number, and much of the time, they end up approving the requested study. So my question is, why make the physician jump through hoops just to get the study done, when ultimately you are going to approve the test if a physician calls? Then again, maybe that’s the point, not every physician will have time in their day to call and appeal, and many of tests will not get done.