Health Insurance 101 for Doctors: Navigating Claims and Coverage

Welcome back to the Allergy, Asthma & Immunology Innovations podcast series on health insurance. This episode focuses on how healthcare providers navigate the complexities of the health insurance approval process for their patients.

This episode is produced in partnership with The Itch Podcast. Our co-hosts, Payel Gupta, MD, and Kortney are joined by Elizabeth Johnson, LPN, CPC, PACS, BCPA. We discuss the challenges doctors face when working with insurance companies and offer helpful tools to make the approval process smoother. Elizabeth shares her insights on the importance of good note-taking, prior authorizations, and the medication approval process. 

The episode is helpful for healthcare providers and patients alike. Patients will get a better understanding of what their healthcare team is doing behind the scenes to get their medication approved.

You can learn more about the podcast and the hosts on ItchPodcast.com. The podcast can be downloaded on all major platforms for listening anytime, anywhere:

This episode is made in collaboration the National Association of Medication Access and Patient Advocacy (NAMAPA). We thank Amgen for sponsoring this episode.

All opinions on the show represent the views of the podcasters and the guest. Sponsorship does not influence content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.

Understanding the medication approval process

Elizabeth Johnson and Dr. Gupta talk about the common challenges doctors face when trying to get medications approved. She explains how to handle prior authorizations and insurance denials, offering practical tips to make the process easier.

Elizabeth also highlights the need for better health insurance education in medical schools. She also shares useful resources for doctors.

Key takeaways about health insurance and doctors

In this episode, we discuss how doctors can gain more confidence in navigating health insurance approvals for their patients.

  • Provider challenges: Learn more about the common hurdles healthcare providers face when trying to get medications approved.
  • Insurance approvals: Understand the complex process of prior authorizations and the importance of accurate documentation.
  • Health insurance resources: Discover helpful resources like the NAMAPA toolkit to assist healthcare providers.
  • Insurance education: Understand why insurance education is important in medical school and residency programs.

Podcast timestamps for health insurance and doctors

  • 01:45 – Elizabeth Johnson introduction
  • 02:58 – Common challenges doctors face in getting medications for patients
  • 05:41 – Dealing with insurance companies: a tough task for doctors
  • 09:08 – Is the approval process the same for all medications?
  • 14:00 – What is the NAMAPA toolkit?
  • 17:08 – What do the NAMAPA toolkit modules look like?
  • 21:11 – Why should insurance education be part of medical training?
  • 22:11 – Resources from manufacturers and pharmaceutical companies
  • 25:46 – How to give doctors this information earlier in their careers

Additional resources for health insurance and doctors