We’re having a harder and harder time getting them paid for. We do have a nonclinical precert team as well, which is helpful. However, I notice that sometimes they don’t include pertinent terms such as metastatic, etc. when submitting requests.
I’m losing my mind with the fact that I can’t call and do a peer-to-peer at my convenience anymore and instead have to schedule them. It’s MADDENING! We’re busy enough, and anytime I have one scheduled, I inevitably have something come up in clinic and miss them. It’s even more frustrating when I learn about the peer-to-peer the day or two prior.
I agree with Krista that many of physician reviewers are not oncologists, which further complicates the issue. INSURANCE!!!