Peer-to-Peer Review

Peer to peer requests are calls between your doctor and a doctor from the insurance company to discuss why the testing, imaging or treatment prescribed is medically necessary. These can occur after insurance denials or occasionally prior to further action by the insurance company. You and your doctor have the right to request that the “peer” from the insurance company be knowledgeable about NETs and/or have comparable expertise as your doctor. In some cases, an insurance company case manager or patient navigator may be able to offer preliminary assistance to help you avoid these requests and coverage denials.