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Partial retraction

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.)

Comments

  1. David PostApril 13, 2023 at 4:45 PM

    Senator: has the Faculty Senate seen a fiscal accounting of how much Penn State is contributing for insurance as administered by Highmark versus Aetna? I know all health care costs more over time, but I don't think there has been much of an increase in my share of premiums. I'm not complaining about that! But the extra expense surely is coming from someplace. Maybe it's really the case that Penn State is contributing more and that the Highmark switch was fundamentally to keep Penn State Health competitive.

    Here's some positive reinforcement for Penn State: in my department there is a colleague who has needed to step away for a few weeks from teaching due to health concerns. My department had made a reference to "another department" (but not to you specifically) and explained that we wanted to cover the classes and deal with this internally as opposed to bumping it to the university level. I think the organization is capable of learning from unforced errors.

    ReplyDelete
    Replies
    1. Esther PrinsApril 14, 2023 at 1:49 PM

      I'm convinced one of the ways PSU will save with Highmark is (a) higher prescription costs for us and (b) denying services. I'm glad your colleague is getting more humane treatment!

      Delete
  2. AlisaApril 13, 2023 at 7:38 PM

    Hallelujah!!! Glory to His name. We praise Him for these victories.

    ReplyDelete
  3. AnonymousApril 14, 2023 at 10:29 AM

    Hooray!

    ReplyDelete

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