Reply to Why TF do we need prior authorization for IVF? How do we change this?

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[quote=Anonymous]Hi All,

My clinic - which for now will remain nameless because I like the doctor - forgot to put in my pre-authorization. My cycle is supposed to start this week. They sent it last week but insurance is saying 15-30 days. This would cancel my cycle. I just had three miscarriages in a row, and I'm in my mid-to-late 30s. Time is of the essence, and I've been trying for 13 months with those three losses in there.

Why the hell do I need pre-authorization? It's obviously medically necessary or I wouldn't do it. People don't just sign up to inject themselves with tons of drugs and risk serious side effects for the hell of it. Now a complete stranger - not even my doctor - gets to decide if I can try for a healthy baby? And take their sweet time doing it?

The kicker: insurance companies pre-authorization section won't talk to you - the patient. So I am paying for insurance and benefits - I chose this company because it covered iVF. And now I need even more permission to get what I'm already paying for?

How do you get insurance to sign the paperwork? How can we force a change in the industry. This is just plain stupid and stressful when we're already in stressful situations.

I appreciate your thoughts on how to fix this. I know everyone's understaffed, but people are making mistakes and it could cost me another 5-6 months of waiting.

Otherwise I just maybe keep trying, keep miscarrying? I've had four losses. What number makes it medically necessary? What number justifies not even needing to go through this waste of a time and money process?

Thanks.[/quote]

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