Making a Way in the Wilderness

Update on my CT scan authorization. PSU's Highmark rep told me yesterday that "Authorizations are valid for 60 days as long as medical documentation does not change." However, I get CT scans every 3 months, so 60 days doesn't help me. It would have to be 90+ days. She wrote back today to say that "an authorization is not required for your CT scans going forward." Hallelujah! <happy dance> I asked whether this applies only to me or to all PSU employees. I haven't heard yet. I suspect it's the former. According to her, it was the medical practice (Mt. Nittany Physicians Group)--not Highmark--that processes authorizations 12-15 days beforehand. They now understand that they can submit authorization requests sooner than this. So I retract my previous comments criticizing Highmark for the 12-15-day timeframe. (But not my comments on other problems with HM.)

Reason #397 that Highmark is worse than Aetna. I just found out from my pulmonologist's office that Aetna didn't require pre-authorization for routine 3-month follow-up CT scans. Highmark does. And they don't allow the medical provider to start the pre-authorization process until about 12-14 days before the target date. May 13 is 3 months, but they won't let my doctor submit the paperwork until May 1. I have no idea how many days it takes to get approval, but it's likely that I'll only find out maybe 1 week beforehand when the CT scan will scheduled. Thankfully the semester will be over so I'll have plenty of flexibility. However, the February scan was scheduled weeks ahead of time, and even then I only had 2-3 options in a 5-day period, one of which was 7am, if I recall. In other words, scheduling could be a bit of a nightmare, especially in November and February when I am teaching and have standing meetings for my department and program, Faculty Senate, r...