Insurance companies are placing increasingly more restrictions on patient care. Whether requiring a pre-certification to visit a specialist or a pre-authorization for a specific medication, physician offices are inundated daily with additional work to ensure that patients are receiving appropriate care. These restrictions result in patient confusion and anxiety, and physicians are becoming seriously concerned that insurers are making medical decisions based merely on cost and not the patient's best interests.
Despite the medical management decisions made in the examination room, the patient-physician relationship is continuously strained by arbitrary limitations placed on them. Even more disturbing is that these decisions are often made by non-medical professionals making decisions based on pre-determined guidelines. Unfortunately, many tests and medications are denied coverage despite the best efforts and appeals by the ordering physician.