04/21/2026
Denied.
Same patient.
Same MRI.
Same clinical note.
My NP is on the peer-to-peerโฆ
clear indication,
evidence-based,
within standard of care.
And itโs trending toward a denial.
So I step in.
โIโm the surgeon.โ
Suddenlyโฆ approved.
No change in pathology.
No change in symptomatology.
No new data.
Just a different voice on the line.
I appreciate the approval. ๐
But medical necessity shouldnโt hinge on
titlesโฆ
timingโฆ
or subjective interpretation in the moment.
It should align with
the documentation,
the imaging,
and established clinical guidelines.
My NPs are highly trained.
Clinically sound.
Trusted extensions of my practice.
They shouldnโt need a different title
to reach the same conclusion.
This is bigger than one case.
Itโs about consistency in how care gets approved. โ๏ธ
