Re "Dad calls foul over medical bill," Column, June 1
David Lazarus is to be commended for going toe to toe with health insurance behemoth Aetna.
Jim Furlan was stonewalled by an insurance company that refused to cover a necessary MRI because he had not gone through Aetna's "prior approval" process. At one point Aetna suggested that the physician who had requested the MRI without prior approval should pay for the test.
Lazarus got Aetna to do the right thing.
Prior approval, in theory, protects patients and insurance companies against unnecessary procedures. In practice it is actively used to place burdensome hurdles in order to improve the company's bottom line while delaying delivery of medically necessary care.
In 2011, Aetna's chief executive received
$9.7 million in pay, money derived from health insurance premiums. He didn't call Furlan to request prior approval.
Howard R. Krauss, MD
Aetna is to be commended for doing the right thing for Furlan. I've been caught in the middle of billing mix-ups and know how maddening they are.