The UR "peer to peer review" scam (California) (California)

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Re: The UR "peer to peer review" scam (California) (California)

Postby bakodoc on Mon Mar 23, 2015 5:03 pm

I guess I can only speak for myself. I provide my mobile number and invite to call any time they are ready... of course within deadline I'm given. My last review, I spoke with the requester twice because he didn't have the records the first time and had answered his assistant's call twice in order to make schedule for total of 4 phone calls for me. The case before that involved 5 calls. Only time I don't get to speak with the requester is when they seem to be avoiding the call. Either they are too busy when I call and never get back to me afterwards.

I can see why some of the reviewers are not very keen to talking with the requester though. If they had bad experiences, perhaps they are young and don't know how to handle it. I've had my own share of bad calls. Some requesters are downright rude. Some conversations begin with their questioning of my credentials from the getgo and they try to out do my credential as if that makes any difference. It's fight for them for some reason. I guess for some reviewers it's the same. Anyway, all I can assure you is that there's no conspiracy. I've worked with numerous UR companies and all of them were very professional and tried to prevent the kind of things you've posted. But I'm sure there are some bad companies as well like there are bad insurance companies. I don't deny the possibility as there are more companies I haven't worked with than I have. Just be courteous. There's really nothing to gain from being rude to the reviewer. They are treatment providers just like you. In my case, I try to see if there's a way to justify approval for fellow docs. There's no quota, there's no bias from the company and there's no pressure either. Some of the companies I work or worked with are major ones you'd know if I told you.
bakodoc
 
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Re: The UR "peer to peer review" scam (California) (California)

Postby suekarp on Wed Mar 25, 2015 6:20 am

Our UR company asks us to get some hours that the requesting doc will be available. Sometimes, it is even in their reports. However, there are many times when our UR physicians call. they cannot get through to the physician, even though they stated that they would be available.
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