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Denial of mayo visit

Posted by nancyeburford @nancyeburford, 5 days ago

I have been denied a visit to Mayo with loads of testing and labs. No diagnosis and different med trials. I thought Mayo took complex cases with a team approach. They would not tell me the real reason for denial. My GP encouraged it. Anyone have a thought on this?’

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vic83 | @vic83 | 1 day ago
In reply to @sueinmn "I had occasion to speak to the Prior Authorization Coordinator at one of my provider's offices..." + (show)
@sueinmn

I had occasion to speak to the Prior Authorization Coordinator at one of my provider's offices yesterday. It was near the end of her workday and it was obvious that she was exhausted and frustrated, yet she was pleasant as could be.

After we concluded our business, I asked her how things were going and she told me "2025 has been a nightmare so far" saying medications and procedures that patients had been having for years were requiring prior authorization - even if they had not changed plans. And many were coming back "Denied" even when the patient met ALL criteria as I did. She said she spent the entire day yesterday filing appeals, and knew all would be granted in the end. She is worried, especially about many of her older patients, who are less savvy about the crazy new processes.

PS. This is even beginning to "bite" many of us who have traditional Medicare with a supplement.

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If anyone is having issue with traditional Medicare, I hope they share this with us. I have multiple doctors at Mayo, don't need more problems.
Regarding your comments, I would ask people to also consider the ADDITIONAL cost to our healthcare because providers need to hire extra people to process all the different claims and appeals. We have an inefficient healthcare system, with a profit motive. We need coverage not choice. We should look to the world to see how other countries have addressed this issue. And socialized medicine does not create delays...lack of doctors and resources creates delays.

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