Eli Kamara MD

Orthopedic Surgeon, specialized in adult reconstructive orthopedic surgery, hip & knee replacements, joint replacement, hip & knee arthroplasty, fracture care.

[Eli Kamara MD @EliKamaraMD]

This is a well documented problem not only with @aetna but all Medicare advantage plans.

https://t.co/2ZxmkFfwLd

I hope @LeaderJohnThune and @SpeakerJohnson will take action to move forward and address these issues with Medicare advantage and reintroduce S.4532 - Improving Seniors’ Timely Access to Care Act.

As a result of this behavior, patients are suffering.

[Eli Kamara MD @EliKamaraMD]

Hey @Aetna @AetnaHelp
Shared with patient permission

We submitted prior authorization on 1/2 for a total knee replacement on 1/22 for a Aetna Medicare advantage patient. It was denied on Saturday 1/18 over the holiday weekend. Now your representatives are saying that since we didn’t appeal on Saturday, the surgery is denied and we need to restart the entire approval process. Additionally, no option was given to appeal the decision. We have spent 2+ hours talking to your staff with no recourse given.

This is inappropriate. Saturday was a holiday weekend. The patient’s family took off work and flew in to support her during the surgery. The patient has failed multiple documented rounds of non-operative treatment, and has a successful knee replacement on her opposite leg. Her X-ray below clearly demonstrates bone on bone arthritis.

This is a clear violation of Medicare guidelines.

Another example of the need for the passage of S.4532 Improving Seniors’ Timely Access to Care Act

@AAOS1 @AAHKS @CMSGov @cmaorg @HHSGov @MedicareGov @AmerMedicalAssn
#claimdenied #respectmyprescription

[Eli Kamara MD @EliKamaraMD]

Todd,
Thanks for the message.

From your email:
“If a provider can supply records in regard to completed physical therapy or an evaluation from a physical therapist stating that they feel the therapy would be ineffective, we would be happy to submit that information on the providers behalf.”

I am happy to submit any requested clinical information regarding the patient’s history. Unfortunately on the phone today for 3+ hours with @Aetna the representative did not give us the option to submit any data, perform a peer to peer, speak to a doctor, or appeal. As a result the patient’s surgery for tomorrow is canceled. It’s inappropriate that it takes a tweet to get an answer from @aetna.

[Eli Kamara MD @EliKamaraMD]

@jointdocShields @NaanDerthaal

[Eli Kamara MD @EliKamaraMD]

@AetnaHelp Thanks we will email you
But an email is not as helpful as a phone call. The surgery is scheduled for tomorrow.

[Eli Kamara MD @EliKamaraMD]

Symptoms and Treatment of Different Types of Kneecap Injuries.
https://t.co/dOAPkXrVDt

[Eli Kamara MD @EliKamaraMD]

Feel a pop, then pain in your knee? It could be an ACL tear.
https://t.co/3qCp1iTLOA

[Eli Kamara MD @EliKamaraMD]

Knee Pain Relief: Exercises, Medications & Self-Care Tips.
https://t.co/h4TcmM1TDF

[Eli Kamara MD @EliKamaraMD]

Average hip, knee replacement patient may be getting younger.
https://t.co/UDhzRSE3Ue

[Eli Kamara MD @EliKamaraMD]

10 Strengthening Exercises for Hip Bursitis.
https://t.co/NgWXroFqYk

[Eli Kamara MD @EliKamaraMD]

What can cause pain in the back of the knee when straightening the leg?
https://t.co/tpYRhVnwON

[Eli Kamara MD @EliKamaraMD]

Multidisciplinary model can cut refracture risk for hospitalized adults with hip fracture.
https://t.co/a86m2aiYeE

[Eli Kamara MD @EliKamaraMD]

9 Home Remedies for Knee Pain.
https://t.co/1pbGn219ZG

[Eli Kamara MD @EliKamaraMD]

More women report hip fractures earlier in life, research finds.
https://t.co/KQsCiGDOrf

[Eli Kamara MD @EliKamaraMD]

What to expect during rehab after hip replacement.
https://t.co/cbOunWLUKy

[Eli Kamara MD @EliKamaraMD]

‘Don’t push into pain!’ How to rescue your knees from everything from torn ligaments to injured tendons.
https://t.co/V2H4HEcwCG

[Eli Kamara MD @EliKamaraMD]

What Is Iliopsoas Bursitis?
https://t.co/D3oHrq0ZaK

[Eli Kamara MD @EliKamaraMD]

Should You Worry About Joints Cracking or Popping?
https://t.co/YdBNor5iCW

[Eli Kamara MD @EliKamaraMD]

From Surgery to Sports: ACL Reconstruction Recovery Explained.
https://t.co/r9SWmEGInn

[Eli Kamara MD @EliKamaraMD]

THA approaches had similar revision rates for femoral neck fracture.
https://t.co/1TyxuI5BqA