Physician Role in Patient Advocacy: Getting to YES During Peer Review
Physicians often lament the days of yore when treatment decisions were made in the exam room and not the insurance company board room. However, a healthcare consultant who specializes in assisting healthcare organization secure coverage for new medical technology says physicians still have a say in individual coverage decisions.
Mary Corkins, Founder of The Reimbursement Group, assists healthcare organizations navigate the ins and outs of securing coverage for technology biologics and medical devices. She consults on the range of challenges new medical products face, from launch to collections and one of the unique services she provides is telephone support during physician peer reviews involving coverage decisions.
Peer-to-Peer conferences, Corkins acknowledges, are "avoided like the plague" for a number of compelling reasons. Historically, peer-to-peer was not an across-the-board protection and not widely available for many denials. Further, companies that did provide peer-to-peer conference . . . .. . . . (to read the remainder of this article, please log in below.) The resource you have requested is available only to current members.
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