How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask FamilyPhysician Your Own Question
FamilyPhysician
FamilyPhysician, MBA, MD
Category: Legal
Satisfied Customers: 12816
Experience:  Legal-medicine issues, business law principles, lecturer in medical-legal issues
1304720
Type Your Legal Question Here...
FamilyPhysician is online now
A new question is answered every 9 seconds

LEGALLY DOES A PHYSICIAN HAVE TO DO A PREAUTHORIZATION ...

Resolved Question:

LEGALLY DOES A PHYSICIAN HAVE TO DO A PREAUTHORIZATION FOR A PATIENT''S PRESCRIPTION THAT HAS BEEN DECLINED BY THEIR INSURANCE COMPANY AT THE PHARMACY
Submitted: 9 years ago.
Category: Legal
Expert:  FamilyPhysician replied 9 years ago.
The simple answer is NO - the primary relationships in health care are the doctor-patient relationship (a professional relationship) and the patient and their insurance company (an agreement for payment of services)

When the insurance company changes rules on what they will pay - the physician is not legally obligated to perform services without additional compensation.

Insurance companies continue to add hassles for physicians without additional payment for these administrative services. Your physician, not your insurance company is the one that should determine your treatment. When you (or your employer) allow insurance companies to write the rules - the physician is in many sense taken out of the decision - and you are allowing adminstrative rather than professional people to treat you.
FamilyPhysician and 7 other Legal Specialists are ready to help you