Anne Bazel Nov 3, 2016 07:58 AM
How fast consultant appointment is obtained...ha, what a joke. Are they saying it is provider's problem if the carrier ignores RFA?
Manila Manila Nov 3, 2016 07:58 AM
The insurance company should focus on tracking their administrative role in medical outcomes before judging physicians who inherit patients with conditions that are needlessly difficult and compounded by psychological factors caused by delays, corrupt utilization review organizations, and failure time and again to abide by timelines.
Dr. Edwin Haronian Nov 3, 2016 07:58 AM
MPN's are just a "legal" mechanism to deny care. As a provider, the minute you take the patients side or provide care that is needed, you will be removed from the list. Rebut a QME REPORT, ask for treatment authorization, provide impairment, and you are out. Then the carriers speak about providing good care which is totally false. As long as a doctor provides cheap care the carriers are happy.
Chrissie Lovold Nov 3, 2016 07:58 AM
I am thrilled that Harbor and others do their best to weed out the "abusers" in their MPNs. But how will the end user, the Claimant or Employer, know who is the best (or worst) performers? It would be nice if those score cards could be posted/accessed... and (just a thought here) that an increased level of payment can be made to Doctors or Facilities on a "pay-for-performance" basis...based on overall outcome.
Miguel Jaramillo Nov 3, 2016 07:58 AM
This is getting out of hand. Now your forcing the IW's to go to physicians that wont provide treatment, or only treatment that the adjusters or UR will authorize, force them to go to these ridiculous QME's that first of are getting overpaid for face time when they have that done over the phone without a certified interpreter at that, and come out with these conclusions and opinions, that are absurd and unreal. I hope this will be the straw that breaks the camels back and we finally do something about it.
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