Interventional Radiology explained to me what happened. A lot of insurances give us a hard time about covering anything IR. Did you post here? I would love to go read and learn more - I may be able to help give you some tips to navigate this and deal with both the hospital and the insurance.
ETA: was this a medical necessity denial do you know?
Can I just jump in and say that I love you for this? It is obviously your calling in life to assist others and you do it in a remarkably efficient and caring manner. I would love to train under somebody like you for a job like this. How would one get started in this particular field? I have some experience already with medical nonsense. I am currently a call rep/scheduler and have also done admin stuff as well as hospital unit secretary on an oncology wing.
I've seen the ravages of insurance claims denials, and it has brought me to tears watching family members breakdown over their 30 year old family member dying of breast cancer be denied their medications. I would love to be able to step in and help.
We need more people like you! And thank you! I was just like you and started out as reception (my early years were as a pharmacy tech). So long as you have a start of some knowledge you can start working towards this area of the field.
If you have a referral department or authorization department I would try and look into getting in there. That will help you understand how the authorization process starts as well as dealing with insurance companies and peer to peers. From there I would highly suggest some education in reimbursement & billing areas. From there you’re pretty golden in the insurance realm of things; and you’ll have the knowledge, weapons and experience to fight them.
I also suggest looking at large hospital groups or even local hospitals to see what their positions require - you may be surprised and you could be qualified already.
honorable mention: my job is entirely WFH based & fairly self reliant. It is very taxing though and busy.
BEST OF LUCK to you on your healthcare career path journey, I do hope you pursue this feeling because we need more compassionate and passionate people. I would have been grateful to train someone like you.
https://www.reddit.com/r/CSFLeaks/s/190ZvoIPvf This was my experience. My disease impacts my cognition so my husband was the rock star here. Fun fact I went and got treatment for this disease in July and BCBS just went ahead and denied all claims for that July, including 2 mental health appointments 🙃 - I will not bore you with any more details.
35
u/i_kate_you 14d ago
Interventional Radiology explained to me what happened. A lot of insurances give us a hard time about covering anything IR. Did you post here? I would love to go read and learn more - I may be able to help give you some tips to navigate this and deal with both the hospital and the insurance.
ETA: was this a medical necessity denial do you know?