Social media has become a vehicle for customer complaints and the companies are listening. Estimates are that almost two-thirds of dissatisfied customers have received a response to their online complaints.
NBC News reported the case of Sally Nix who has managed to survive despite several autoimmune disorders since 2011. She has had spinal and brain surgeries to no avail. Her first glimmer of hope occurred when Sally began intravenous immunoglobulin (IVIG) infusions. Until then, nothing had worked. The therapy involves using healthy antibodies from donors’ blood plasma.
Sally naturally became upset upon learning that her insurance company would no longer pay for her infusions.
When she discovered that the insurance company was refusing to cover the infusions, Sally turned to Instagram and Facebook to find others who were also dependent on life-saving medications.
Sally, age 53, would have to pay, out of pocket, $13,000 at four-week intervals, which she could not afford. She admittedly was “raising Cain.” Sally posted that there are times when people must halt wrongdoings and noted that calling out abuse from health insurance companies qualifies.
Opposing Views
Understandably, patients and insurers see the issue in a different light. Insurers view the delays as a cost-cutting measure where doctors must first secure approval prior to ordering tests and prescription medication. Patients and doctors often find the process frustrating and a reminder that in some instances delays can cause death.
In an unusual turn of events, patients and some physicians have begun publicly shaming insurance payors via social media in order to bring awareness.
Dr. Shehzad Saeed concedes that it is unfortunate that he has had to resort to embarrassing the payors and that this form of complaining has become routine.
Another serious case was presented online by Eunice Stallman, M.D. of Idaho who reported that Zoey, her nine-month-old daughter had been refused prior authorization for a $225 pill that needed to be taken two times each day in order to shrink a large tumor in her brain.
Transparency
The government has suggested several ways to reform prior authorization. Insurance companies would be required to use more transparency and improve their time to respond. The rules would apply to Medicare, Medicare Advantage, and Medicaid plans. Employer-sponsored plans would not be included in these changes so approximately half of the nation would not benefit.
Hope is on the Horizon
A few major insurers have decided to ease mandates for patients and doctors and some states have enacted laws to limit prior authorization use.
