Oncologist fights denial on social media and wins!
Physicians are becoming increasingly frustrated with denials from insurance carriers. To get their patients the care they need, providers need to add time to their busy schedules to anticipate and plan for time to appeal these denials. When one breast oncologist received a denial after a peer-to-peer discussion, she decided to take her case to social media.
This article in Medscape Oncologist to Insurer: ‘This Denial Will Not Stand.”, details a situation that Dr. Rebecca Shatsky, a breast oncologist found herself in when she received a prior authorization denial for pembrolizumab (Keytruda) to treat her patient with stage IIIc triple-negative breast cancer (TNBC). Dr. Shatsky appealed the decision. She was frustrated when the reviewer, who was not a breast oncologist, continued to deny the treatment she felt might prolong her patient's life. After the denial, she took to Twitter to express her frustration with the process. Her thread received tens of thousands of likes and hundreds of comments. The following day Dr. Shatsky received a call from the insurance company's vice president telling her the drug was approved.
Medical Mutual's practice tip, Social Media Risks in Healthcare, provides guidance on avoiding risk in social media.