07/07/2026
It has been another morning dealing with this. . .
๐ค ๐๐ฆ๐๐ ๐ข๐ง๐ ๐๐๐ฅ๐ฅ๐ข๐ง๐ ๐ ๐ฉ๐ฅ๐ฎ๐ฆ๐๐๐ซ, ๐๐ฅ๐๐๐ญ๐ซ๐ข๐๐ข๐๐ง, ๐๐ญ๐ญ๐จ๐ซ๐ง๐๐ฒ, ๐๐๐๐จ๐ฎ๐ง๐ญ๐๐ง๐ญ, ๐จ๐ซ ๐ฆ๐๐๐ก๐๐ง๐ข๐ ๐๐ง๐ ๐ฌ๐๐ฒ๐ข๐ง๐ :
"๐'๐ฅ ๐ญ๐ช๐ฌ๐ฆ ๐บ๐ฐ๐ถ ๐ต๐ฐ ๐ฅ๐ฐ ๐ด๐ฐ๐ฎ๐ฆ ๐ธ๐ฐ๐ณ๐ฌ ๐ง๐ฐ๐ณ ๐ฎ๐ฆ. ๐'๐ฎ ๐ฏ๐ฐ๐ต ๐จ๐ฐ๐ช๐ฏ๐จ ๐ต๐ฐ ๐ฑ๐ข๐บ ๐บ๐ฐ๐ถ ๐ง๐ฐ๐ณ ๐ช๐ต. ๐๐ญ๐ด๐ฐ, ๐ช๐ง ๐บ๐ฐ๐ถ ๐ฅ๐ฐ๐ฏ'๐ต ๐ฅ๐ฐ ๐ช๐ต, ๐'๐ฎ ๐จ๐ฐ๐ช๐ฏ๐จ ๐ต๐ฐ ๐ฎ๐ข๐ฌ๐ฆ ๐ญ๐ช๐ง๐ฆ ๐ฅ๐ช๐ง๐ง๐ช๐ค๐ถ๐ญ๐ต ๐ง๐ฐ๐ณ ๐ด๐ฐ๐ฎ๐ฆ๐ฐ๐ฏ๐ฆ ๐ฆ๐ญ๐ด๐ฆ."
You'd probably get laughed out of the room.
๐๐๐ญ ๐ญ๐ก๐๐ญ'๐ฌ ๐๐ฌ๐ฌ๐๐ง๐ญ๐ข๐๐ฅ๐ฅ๐ฒ ๐ก๐จ๐ฐ ๐ฉ๐ซ๐ข๐จ๐ซ ๐๐ฎ๐ญ๐ก๐จ๐ซ๐ข๐ณ๐๐ญ๐ข๐จ๐ง๐ฌ ๐ฐ๐จ๐ซ๐ค.
For those who aren't familiar, a prior authorization is when an insurance company requires your doctor's office to complete extra paperwork, make phone calls, submit records, and justify a medication or treatment that your doctor has already determined you need.
The interesting part? Insurance companies don't pay physicians or their staff for this work.
Years ago, a physician got so frustrated with this arrangement that he sued over the time spent completing prior authorizations. In Gibson v. Medco Health Solutions (2008), the court agreed that physicians should not be expected to perform work for free and awarded compensation for the physician's time and costs.
We happen to agree.
So beginning January 1st of this year, we started sending invoices to insurance companies for prior authorization work completed by our office.
Current score:
๐ฐ Invoices submitted: Many
๐ฐ Invoices paid: Zero
๐ฌ Insurance companies confused by receiving an invoice: Several
๐ Insurance company employees trying to figure out why we sent a bill: More than a few
In fact, we're preparing to send a couple of insurance companies to collections because, believe it or not, we expect to be paid for work we perform.
Now, before anyone thinks this is about the moneyโit really isn't.
Our goal isn't for insurance companies to pay us for prior authorizations.
๐๐ฎ๐ซ ๐ ๐จ๐๐ฅ ๐ข๐ฌ ๐๐จ๐ซ ๐ญ๐ก๐๐ฆ ๐ญ๐จ ๐ฌ๐ญ๐จ๐ฉ ๐ซ๐๐ช๐ฎ๐ข๐ซ๐ข๐ง๐ ๐ฎ๐ง๐ง๐๐๐๐ฌ๐ฌ๐๐ซ๐ฒ ๐ฉ๐ซ๐ข๐จ๐ซ ๐๐ฎ๐ญ๐ก๐จ๐ซ๐ข๐ณ๐๐ญ๐ข๐จ๐ง๐ฌ ๐ข๐ง ๐ญ๐ก๐ ๐๐ข๐ซ๐ฌ๐ญ ๐ฉ๐ฅ๐๐๐.
If an insurance company knows every prior authorization request generates a bill, maybe they'll decide it's easier to simply approve the medication your doctor prescribed rather than creating more paperwork, delays, frustration, and barriers to care.
We'll keep advocating for our patients, pushing back against unnecessary bureaucracy, and looking for ways to make healthcare a little more sensible.
Because your healthcare should be decided by you and your doctorโnot by whoever designed the latest paperwork form. ๐ฉบ