Preapproved in the nick of time

Paperwork. In healthcare these days, it comes with the territory--in electronic form or otherwise.

And while it’s a common, everyday part of our lives—as patients or providers—it’s never a slam dunk.

William Pfister, a resident of Eugene, Ore., seemed to instinctively know that so he was especially grateful to his doctor, Michael Laurie, MD, and the staff at PeaceHealth Medical Group Barger clinic in Eugene for their work on his behalf.

After being referred to a specialist, William set up the appointment and then waited for preapproval on an imaging test required for the visit. The clock was ticking.

Fortunately, Dr. Laurie’s medical assistant, April Pruitt, was quickly on top of things.

Getting preapproval from health insurance plans can be complex, especially since rules for different types of services can vary by insurance company. And specialized tests such as MRI, CT scans, densitometry, nuclear scans or ultrasound often require extra steps.

“Preapprovals involve going through the patient’s chart and making the case for what’s being ordered,” April said. Pre-authorization homework is painstakingly detailed and somewhat tedious. “I was having to dig deeper at every turn.”

Typically, when preapprovals are issued, patients move on without needing to pay much attention to the work that went on in the background.

For William, there had been some worry that approval would be delayed and further postpone the rest of his care, April said. Fortunately, the green light from the insurance company came just in “the nick of time, on the day of the specialist appointment!”

William wrote in. “I would like to thank Dr. Laurie and his staff for all the help and assistance in getting my insurance approved.”

Simple words of gratitude…but heartfelt ones, from someone who knows paperwork shouldn’t be a thankless part of the job.