Letter to the editor: Insurance preapproval process is frustrating, cumbersome

February 10, 2014

A reader proposes alternatives to the need to obtain insurance company preapprovals for treatments and procedures.

As an ophthalmologist I have many disturbing encounters with insurance companies and pharmacies. First, it takes more than an hour of my secretary’s time, and quite often my time, to get approval for tests such as magnetic resonance imaging when I have to request to talk to a physician to get approval for such tests or even emergency procedures such as laser surgery for retinal hemorrhage.

Insurance companies prefer to pay only for generic medications, which is fine, but occasionally a patient may need a drug not yet available generically. In cases where generic medications are ineffective, the ordeal becomes cumbersome for the patient, my secretary, and me.

The solution is legislation to 1) create single-payer insurance, 2) reduce the red tape for approval of tests, procedures and medications, and 3) enact legislation that  pharmacies must honor a) when the prescription is marked “dispense as written” to give only the generic substitute of the drug prescribed and b) deal with the insurance company when the prescription is marked ‘medical necessity.’

Heskel M. Haddad, MD

New York, New York