Less Burnout Leads to Better Care

Prior authorization lets insurers delay or deny doctor-ordered, guideline-based care—often when any delay matters.. The system is arbitrary, opaque, and misaligned with patient safety, creating different outcomes for the same diagnosis and pushing families into appeals while disease marches on. This piece explains why Americans are outraged and outlines practical reforms to replace PA with timely, evidence-based approvals.

Insurance said “not medically necessary,” but your pain, mobility limits, and daily life say otherwise. This guide breaks down how to overturn a lipedema surgery denial without burning out. You’ll learn exactly how prior authorization works, why claims get rejected (hint: missing magic words like “tenderness”), and the precise steps to win an appeal: obtain the plan’s policy, map every criterion, have your clinician update notes and a Letter of Medical Necessity to match those bullets, submit one clean appeal packet, push for a peer-to-peer review, and escalate to an external review if needed. We include copy-and-send scripts, a printable checklist, and clinician shortcuts so you’re not playing claims clerk all day. Speak the insurer’s language—line by line—and tip the decision in your favor.