Pre-AuthorizationPosted by insurance_midwest

Prior authorization denied for surgery my doctor says I need

My orthopedic surgeon recommended knee surgery. Submitted prior auth and insurance denied it saying I need to try 6 more weeks of physical therapy first. Ive ALREADY done 12 weeks of PT with no improvement.

My doctor is furious and wrote a detailed letter. Do peer to peer reviews actually work? How do I escalate this?

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Prior authorization denied for surgery my doctor says I need | ClaimCave