Some posts are simple and don’t require many words.
Mayo Clinic Urology dept… well it started at 100% and I can honestly say they are good – real good – but when it comes to patient first or process and time – patient loses if they pay with insurance.
Let me explain. National Imaging Association denies the C-11 Pet Scan which would be the most likely test to determine the source of my recurrent prostate cancer. What they require is a Peer-to-Peer consultation with the folks at the Mayo Clinic.
Why? Likely because this particular Pet scan is so highly specialized that the NIA folks need to be “convinced” (my word) that its useful in my case. To be fair, Dr. Kwon, through the Mayo pre-certification dept sent extensive material to help them understand. Do I think the folks at NIA read it – na…not a chance.
But the problem is – Dr. Kwon and the Mayo Urology folks don’t (won’t) do peer-to-peer consultations with insurance companies. I was told if they did that is all they would do and therefore get no scans done.
Wait a minute…time out. You’re telling me that you (the Mayo Clinic) can’t hire someone with clinical urology experience to handle the interaction with insurance companies so that patients (like me) don’t get caught in the health insurance circle of death?
Sorry, but it is unacceptable that no one with enough specialized knowledge from Mayo Urology can take the time needed to do the peer-to-peer knowing that this test is “the” test needed to help me get appropriate direction needed for an effective treatment.
One call, but the Mayo Clinic won’t make that… at least that’s what I have been told for two days. So much for the patient coming first. Remember I (your patient) didn’t create this screwed up system of health care or payment system. I just need cooperation so I can move forward to eliminate this disease once and for all.
You sure you won’t make the peer-to-peer call? Please!