Many patients have become dissatisfied by limitations and have dropped out of plans. Changes in employment or marital status sometimes remove patients from plans. Those patients then have a choice of whether to remain with the orthopaedist or seek care elsewhere. If the doctor has established a bond with his or her patients, they will choose to remain with the practice and pay for their care themselves. Because third-party payers and employers are well organized and present a seemingly united front, it is important for the orthopaedist and patient to present a united front as well.
Physicians are their patients' advocates.
Their common goal is healthcare. If treatment is delayed or denied because prior authorization must be obtained it is essential that the utilization review specialist explain this to the patient. If the delay or denial is not acceptable, the patient must understand that it is not the orthopaedist or the staff causing the problem. It is essential that patients realize that the doctor's office is part of the solution, not part of the problem. Although the amount of paperwork can be overwhelming, it is best to perceive it as a challenge.