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Ron Perelman Dec 1, 2020 a 6:12 am PST
She is 100% correct,but I doubt if will change. If you chose the doctor to be in your MPN, trust him. If you can’t, he shouldn’t be in the network.
Randy Bugg Dec 1, 2020 a 8:12 am PST
That would be ideal, however, to realize that goal the removal of the geo-access requirement would be necessary. As long as that is part of the MPN statute(s), networks cannot simply be limited to "trusted" physicians. The key issue with UR, in my opinion, is that quickly became a profit center for many claim payers and as a result adjusters were given no alternative but to send every request to UR. I believe the quickest way to reform would be to prohibit common ownership or "revenue" sharing between payers and URO's. The overall message that I arrive at over and over is, "you can't codify common sense" Have an excellent day!