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Getting a pre-auth for surgery in FL from a PA comp company
#1
Does anyone here know how to get a PA company to preauthorise (sp) back surgery in FL.? I had a l4-l5-s1 fusion done in PA 5 yrs ago, and it needs to be revised. I moved to FL after the surgery to get away from the cold, and the comp claim was settled as far as wages go, but the med was left open. My Dr. down here will not do the operation without knowing up front he will get paid, especially for the new(expensive) hardware, but the PA comp copmany will not give him a preauth. I have a PA atty working on it, but any info would be appreciated.
 
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#2
Have comp court order it.
Signature/Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information.........
 
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#3
I believe I answered this on PA forum, but as I stated there, pre-authorization is often required by doctors, but most workers' compensation carriers in PA take the position that they do not have to do anything until they receive an actual bill, and they will not receive an actual bill until the procedure has been performed, and if they don't pre-authorize, the procedure never gets performed, so they never have to pay. If that seemed like a big illogical circle, that is because it is. Your attorney has a difficult fight, the best you can do is give him whatever information he needs and hope that the judge assigned is sympathetic to your position.
Timothy D. Belt
DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The answer given is based only on the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.
 
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