I have a UR question, I had spine surgery that had complications and before the surgeon released me from surgery he decided he wanted out of work comp and put in a transfer of care to a new neurosurgeon to replace him. It was approved but the 1st neurosurgeon I selected from the MPN after review of 2 years of my medical records declined to see me so I selected another surgeon, it was approved also. The UR was approved for transfer of care, there was also an approval for 1 internal consultation in the same UR authorization letter and in the authorization letter from the adjuster to the new surgeon as a secondary treater as stated in her letter the adjuster stated she was going to send 2 years of medical records.
This new surgeon never acted as a secondary treater and the report stated on the front page of his report consultation, he never released me from surgical care and in fact recommended a 2 level fusion and in his only report he stated “this was a onetime evaluation and no further follow-up will be provided to the patient” the 2 years of medical records the adjuster stated to the surgeon were never mentioned in this surgeon’s report, just the films and 2 reports I brought with me.
Would I be able to enforce this UR approval for transfer of care to replace the original surgeon after more than 1 year?