There is a widespread myth in healthcare that only front-desk staff and revenue cycle teams deal with insurance nonsense. The thinking goes: when things get really bad, that’s when the physician steps in, calls the insurance plan directly, and everything magically gets handled.
But here’s the truth nobody wants to admit: Even physicians get treated with zero respect when they call.
A board-certified oncologist trying to get urgent chemo approved? Still gets transferred. Still gets read a script by someone who has no clue what oncology even means. Still gets told to “fax in medical records” or “check the insurance portal.”
And let’s be honest. The insurance portal is still trash.
The Illusion of Medical Authority.
Imagine this. A physician who went to school for over a decade, trained in complex cancer treatments, is on the phone with a call center rep who keeps asking them to spell the word “chemotherapy.” The physician is calling to overturn a denial for a PET scan to assess metastasis. The insurance rep asks what the scan is for. Then asks for a diagnosis code and finally why the diagnosis code was used.
This is not a joke. This is every day.
The physician explains that the patient has aggressive late-stage breast cancer. The person on the other end of the call responds that it does not meet medical necessity criteria, and they must appeal in writing. That same appeal will go to a nurse reviewer with zero experience in oncology. Or worse, a third-party vendor whose idea of medical necessity is based on a checklist, not clinical judgment.
Sound familiar? It’s the same script “Jennifer” and “Brad” read to your billing staff in Part 1. Same runaround. Same nonsense. Different victim.
Revenue Staff? Ignored. Physicians? Still Ignored.
Revenue cycle staff are used to being disrespected. They are dismissed as “clerical staff” even though they are the ones doing the daily battle to get claims paid. But when a physician finally gets on the phone and still gets the runaround, that’s when reality hits.
This is not about a job title. It is about power. And insurance companies do not care if the person calling is a front-desk employee, a billing director, or the specialist who actually performed the surgery.
Every call is treated like an inconvenience. Every request is met with suspicion. Every caller is assumed to be lying until proven otherwise.
Clinical Knowledge Means Nothing.
Physicians are being asked to explain basic anatomy to customer service reps who have never set foot in a hospital. One oncologist was told that a radiation treatment plan needed to be justified with physical therapy notes. Another was told to submit a peer-to-peer review request only to wait two weeks for a callback that never came.
When the callback finally came, it was from a non-clinical representative. And no, they were not authorized to approve anything. Just to collect “more information.”
Remember the Transfer Tango from Part 1? Physicians get it too. Department to department. Hold music. Disconnections. No callbacks. The promise of speaking to “someone who can help” leads absolutely nowhere.
Insurance companies know that when a physician calls, time is critical. They know a call means a patient’s treatment is on the line. And they still make the physician go through 6 call transfers and 4 insurance portals clicks just to be told to fax it over.
Meanwhile, the patient waits. And waits. And waits.
The Emotional Toll.
No one talks about the impact on physicians. These are people trained to save lives. They are not trained to argue with scripts and phone systems. But now they spend hours each week fighting for authorizations that should have been automatic.
They are burned out. Frustrated. Disrespected. And most of all, helpless. Not because they lack skill, but because the insurance machine is built to exhaust everyone, even the ones with MDs behind their names.
This is the real strategy, just like we talked about in Part 1: make it so painful that people give up. Insurance companies do not say no outright. They just create enough roadblocks until the physician stops asking, reschedules, or takes the financial hit.
And you know what? It works.
What Can Actually Be Done?
Insurance companies do this on purpose. That is the real scam. Giving up is exactly what they want. Here’s what physicians can do to fight back:
Document Everything, Build Your Case.
- Record every reference number, rep name, call time, and exact denial reason.
- Track patterns by insurance companies that pull this crap most often.
- Use this data when negotiating contracts or filing formal complaints.
Demand Peer-to-Peer Reviews Immediately.
- Don’t accept “submit in writing” as the first answer.
- Push for medical director review when clinical reps are unavailable.
- Document every time peer reviews are denied, delayed, or mysteriously “lost”.
File Complaints That Actually Produce Results.
- State Insurance Commissioner for pattern delays and bad faith denials.
- CMS(Centers for Medicare and Medicaid) complaints for Medicare Advantage inappropriate denials.
- Department of Labor complaints for ERISA plan violations.
Build Internal Workarounds (Because You Shouldn’t Have To, But Here We Are).
- Designate authorization specialists who learn each insurance plan’s specific rules.
- Create templated appeal letters citing clinical guidelines and case law.
- Establish direct relationships with insurance company medical directors when possible.
Support Real Policy Changes.
- Push for gold card laws in your state (automatic approvals for high-performing providers).
- Support prior authorization reform legislation.
- Share your documentation with legislators and the media.
Consider Strategic Moves.
- Drop contracts with the worst offenders if financially viable.
- Join provider coalitions to negotiate collectively.
- Support class action litigation for systematic delays of care.
This Is Part 2. The Fight Isn’t Over.
In Part 1, we showed the nightmare from the revenue billing side. The offshore call scripts. The insurance portal runaround. The transfer tango. The deliberate strategy to make you give up.
In Part 2, we exposed what happens when physicians, the ones with a decade of training and actual clinical expertise, enter the ring and still get knocked down by the same crap.
There is no magic phone number. No title makes the system automatically listen. No credential stops them from reading their bogus script.
But here’s what they’re not counting on: medical offices that document everything, file complaints, refuse bad contracts, and organize everything together. Every denied claim that gets appealed. Every complaint filed with regulators. Every physican who speaks up publicly. Every practice that says “no more” and drops its worst contracts.
The insurance industry is counting on our exhaustion. They’re betting we’ll give up.
We document. We escalate. We organize. And we make them answer for every unnecessary delay, every bogus denial, every hour wasted on hold.
Because on the other end of every authorization battle is a patient who deserves better. And a healthcare system that’s supposed to actually care for people, not maximize insurance company profits.
Healthcare is a joke. Medical care is an illusion. No one is laughing anymore.
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