Dr. Quarles’s Story

In post-acute care, I encountered a 61-year-old father of three teenagers, who endured a debilitating stroke due to a 10-day delay in receiving his blood pressure medication, awaiting prior authorization from Cigna/Express Scripts. This tragic event has left him paralyzed, underscoring the dire consequences of bureaucratic hurdles in accessing essential medications.

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Annemarie’s Story

Chronic and rare condition sufferers, like myself, rely on daily anti-convulsants for survival. Prior authorization hurdles cause delayed refills or form changes, resulting in prolonged lapses without vital medication access.

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Dr. Jung’s Story

Treating pediatric uveitis, a serious eye inflammation, requires potent steroids like difluprednate. Despite urgent need, insurance denied it, mandating futile trial of weaker drops. Patient’s condition worsened, necessitating oral steroids with adverse effects. Insurance-induced delays led to demoralizing battles, undermining care quality. As a dedicated practitioner, advocating for patients becomes exhausting amidst administrative obstacles. These…

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Dr. Swope’s Story

In palliative care, I support a 44-year-old mother with stage 4 colon cancer, aiming to enhance her time with her children amidst her illness. Despite managing her pain to uphold this, prior authorization hurdles for pain meds consistently stall care, leaving her bedridden on severe pain days. Each delay chips away at her morale, fueling…

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Dr. Culberson’s Story

A patient called reporting his insurance (United) denied renewal for his ventilator, essential for his survival. Despite clear medical necessity documented by a pulmonologist, appeals were fruitless due to bureaucratic delays. Urgently, I persuaded the oxygen company to delay pickup, scheduled a doc-to-doc, and resubmitted documentation. Thankfully, the appeal was eventually accepted. Had I lacked…

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Dr. Keith’s Story

In February 2023 I saw an elderly patient with acute abdominal pain at our outpatient clinic. Their exam was concerning so I obtained a STAT same day outpatient CT abdomen/pelvis, which showed acute colitis, clearly explaining her pain. I then direct admitted her to our hospital, bypassing the ER and saving the system money and…

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