11Alive: “Gwinnett woman highlights struggles with health insurance authorization”

11Alive: "Ossoff reportedly received dozens of reports from Georgia patients, who have reported that prior authorization issues with their insurance companies have resulted in delays and denials of medically necessary health care that lead, in some cases, to untreated life-threatening conditions and severe financial hardship."

Atlanta, Ga. - 11Alive Atlanta is highlighting U.S. Senator Jon Ossoff's investigation that details reports from Georgians who say insurance companies are denying or delaying care doctors say they need.

In the last month, Sen. Ossoff has released the second and third reports of his ongoing investigation, which highlight stories from Georgia patients who have reported that insurance delays and denials of medically necessary health care have led, in some cases, to untreated life-threatening conditions, and/or severe financial hardship.

Sen. Ossoff's first report detailed stories of Georgians who report they have been delaying necessary care and are paying thousands more for care after the loss of the ACA tax credits, with some saying they've lost insurance altogether because of the high costs.

See key excepts below from 11Alive's report:

9/25: Gwinnett woman highlights struggles with health insurance authorization

11Alive // Joe Ripley

• On the outside, it might look like smiles, laughter and bliss. But on the inside, Megan Bliss was dealt a brutal blow. From rising healthcare costs to cuts to medical services to delays in critical care, she has experienced all three firsthand as she fights to regain a sense of normalcy.

• A stroke left her in immense pain and out of work for years. 

• "About five years ago, I had a hemorrhagic stroke," Bliss said. "It affected the left side of my body and basically a lot of the typical things, really had to learn how to walk again."

• She said doctors prescribed her a DRG stimulator, a medical device designed to help ease her pain. But insurance denied her for months, saying Bliss had not met the proper requirements.

• "This puts a ton of pressure on my husband being the only income, and it's emotionally very defeating," Bliss said. "It's pure insanity to me that those people who are not my doctor were making decisions about my healthcare. We pay money to the insurance company every two weeks, a huge chunk of money. I feel like that should be enough."

• Bliss was denied due to prior authorization, a process that acts as a check or balance between a provider's recommendation and what an insurer agrees to pay for.

• Ossoff reportedly received dozens of reports from Georgia patients, who have reported that prior authorization issues with their insurance companies have resulted in delays and denials of medically necessary health care that lead, in some cases, to untreated life-threatening conditions and severe financial hardship.

• Meantime, Megan Bliss finally got approved for her device after seven months. Now, the wait is on to book her procedure and pursue a less painful life.

• "Hopefully it's not too long a wait before I can do the permanent implant and get a little bit of my normal life back," Bliss said.

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