Medicare Advantage has been controversial this year with several major health systems dropping plan coverage due to denials, and some physicians following suit.
More than half of the nation's seniors are covered under Medicare Advantage plans, and health plan leaders see the number growing. But providers are less enthralled with MA plans, and the federal government has been looking into billing fraud allegations and high denial rates.
"It's gotten much, much worse [than it was a year ago]. It was bad back then, but now it's five times worse," he said during a panel at the Becker's 29th Annual Meeting in October. "Every time I turn on the TV, I see ads for Medicare Advantage and basically Medicare Advantage, they'll disapprove any surgery you apply for. A lot of times I have to tell patients, look, you have to wait until you can unenroll and then do that. Then you can have your surgery."
Dr. Deutsch recounted a recent instance where his team wanted to perform a cervical fusion with an interbody implant. Medicare Advantage denied the interbody device, which he hadn't heard from other payers.
"They'll deny surgeries for the craziest reasons," he said, later adding, "The only thing we can do is to try to educate patients not to enroll in it."
https://www.beckersspine.com/spine/...age-is-getting-much-much-worse-for-spine.html
tell patients, look, you have to wait until you can unenroll and then do that. Then you can have your surgery.
Why doctors should not sell insurance . . .
More than half of the nation's seniors are covered under Medicare Advantage plans, and health plan leaders see the number growing. But providers are less enthralled with MA plans, and the federal government has been looking into billing fraud allegations and high denial rates.
"It's gotten much, much worse [than it was a year ago]. It was bad back then, but now it's five times worse," he said during a panel at the Becker's 29th Annual Meeting in October. "Every time I turn on the TV, I see ads for Medicare Advantage and basically Medicare Advantage, they'll disapprove any surgery you apply for. A lot of times I have to tell patients, look, you have to wait until you can unenroll and then do that. Then you can have your surgery."
Dr. Deutsch recounted a recent instance where his team wanted to perform a cervical fusion with an interbody implant. Medicare Advantage denied the interbody device, which he hadn't heard from other payers.
"They'll deny surgeries for the craziest reasons," he said, later adding, "The only thing we can do is to try to educate patients not to enroll in it."
https://www.beckersspine.com/spine/...age-is-getting-much-much-worse-for-spine.html
tell patients, look, you have to wait until you can unenroll and then do that. Then you can have your surgery.
Why doctors should not sell insurance . . .
