Patients Stuck with Bills After Insurers Don’t Pay as Promised

February 7, 2020

(Kaiser Health News) – The billing quagmire into which the Markleys fell is often called “retrospective denial” and is generating attention and anger from patients and providers, as insurers require preapproval — sometimes called “prior authorization” — for a widening array of procedures, drugs and tests. While prior authorization was traditionally required only for expensive, elective or new procedures, such as a hip replacement or bypass surgery, some insurers now require it for even the renewal of some prescription drugs. Those preapprovals are frequently time-limited.