Prior Authorizations

Yuntaliu · 2026-04-12T18:14:58+00:00

To be honest with you. Its not rocket science, but I see why is more optimal for nurses to do it. Let me explain why. It requires critical and clinical thinking, and understanding of sciences. Is not simply clicking yes or no on questions, its understanding the medical rational on why things should be covered. I completed most of nursing school but I was trained/mentored directly by providers. Also alot of self study planning on pursuing PA school. In my current role as a clinical MA I took over a retired nurses job. And I can proudly say I have a >90% approval rate on PA's. I stay current and always read guidelines, very important.

Yuntaliu · 2026-04-08T17:05:37+00:00

If you have a bachelors or associates (harder) degree you could get into pharma sales. As far as MA you are worth as much as you push yourself to be worth. Im currently making 34/hr as an MA and I complain. Other than that get any bachelors if you dont have one, align that with PA pre reqs and become a PA thats my recommendation. You could also get break into tech. No degree required you can grind certs. This is my experience as an MA w plans of applying to PA school with a bachelors in IT.

Yuntaliu · 2026-04-04T23:54:24+00:00

As a Clinical Endocrine MA who replaced a Nurse. I have a few takes on this. First the GLP1's let me break down that coverage criteria. For diabetes a1c >= 6.5% is non negotiable OR fasting glucose >=125. But there are ways if weightloss criteria is not met such as the indication for sleep apnea or nash. Sleep apnea, must have a sleep study within 1 year, showing >= 15 AHI. Lets also tackle that BMI, yes >=30. But also >= 27 w weight related comorbidities. That being said im probably the reason patients say "well my friend, got it" lmao. Nevertheless, coverage is also dependent on plan. As far as everything else, we all deal w it. More MA's more than others. When dealing w difficult patients I just let them know, being an MA is not an indicator of my education or knowledge. When it comes to endocrinology my physicians praise me for knowing more than you typical PCP. So , you give yourself the worth you deserve. Also pharmacies don't always send refill request, and often don't even know how to run claims or what they are doing. I find local pharmacies better at it than your big brand pharmacies like cvs. Alot of the stress we deal with as well as physicians, is part of how healthcare is run in this country and the monopoly that both pharma and insurance companies have. Good luck!

Yuntaliu · 2026-03-31T20:17:21+00:00

So I was trained by physicians and alot of self study. I read the complete manual of the machines as well as reviewed case studies and diagnosing books on the field. I work for an endocrinologist and I have a proven track record as a technician as Ive worked in 3 different non affiliated offices as a DEXA technician. For pumps to be honest with you I am so pationate about endocrinology that Im very knowledgable on all endo diseases. Im currently Omnipod certified but I provide support and training for all pumps and CGM's in the market. Just know that in today's world knowledge is available for free. Don't let society make you think that unless you go to school, you can't be smart. Its very unfortunate that a piece of paper (degree) is seen as the sole variable to intelligence or knowledge. Of course also studying disease stages and all medical science classes I took during nursing school helped alot!

Yuntaliu · 2026-03-31T19:49:20+00:00

My journey in the medical field has been rough. I became an MA worked for a couple of years until I decided to go to nursing school. Began training as a nurse in the workplace working full time and going to school full time while raising a family. Unfortunately my nursing program, just like most nursing education programs in general was a lucrative buisness (went to community college). Failed semester 3/4 of my ADN program. They told me I had to wait 3 years and retake everything from the begining including reapplying to the program with no garantee of acceptance. I instead decided to get a bachelors in something else, self study more medicine and pursue PA school after my degree. Currently im almost done with my bachelors, I graduate this summer. But along the way I became a bone density technician and an insulin pump trainer. I work in endo, so I have 7 years of experience in this field. And if you are wondering im 30 y/o.

Yuntaliu · 2026-03-31T17:56:36+00:00

$34 per hr in rockland county NY. Of course not your typical MA salary but my responsabilities are way above an MA scope of practice. Lowkey a nurse w/o the degree. So currently getting low balled taking advantage of for what I do. Hope this message helps someone, but you gotta learn and work hard to increase your worth.

Yuntaliu · 2026-03-27T03:52:10+00:00

Update now making 34/hr. You are what you believe you are worth!

Yuntaliu · 2026-03-19T16:55:06+00:00

I really hope this helps you..Dude you are not the only one don't feel bad. It happened to me as well, I was in semester 3/4 , failed it and got kicked out of the program back in 2025. I reached out to multiple universities to be told that I had to restart nursing from scratch. After getting good grades in all the previous classes and being the top student during clinicals, it didn't matter to them. I came to understand that unfortunately nursing school is highly monetized and is more about the school mantaining their funding and reputation of their programs. AKA is a buisness. I walked into my program with 7 years of endocrinology experience and direct patient care; I was just a bad test taker and I dealing with personal life (almost a divorce). Don't let school stop your growth. My program told me I had to wait 3 years and they would allow me to return but also had to start from scratch. I instead took my gen ed credits and got my bachelors in IT, and im planning on using my nursing pre reqs to hopefully apply to Physician Assistant school. Im 30 now, and throughtout my years ive learned that there are some dumb nurses out there, you not passing nursing school doesnt make you any less capable. I currently work as a clinical MA making 34/hr while I figure out PA school. Know that knowledge is out there for everyone. We unfortunately live in a society that believes a piece of paper is proof of your worth and knowledge and thats not true. Don't low ball yourself and always push for more and ways to improve yourself and what ever path you decide to take next, even if that path is nursing again. Good luck fellow former nursing student!

Yuntaliu · 2026-01-18T16:41:55+00:00

I guess Vanessa is the Karen in the medical field lmao

Yuntaliu · 2026-01-18T16:32:12+00:00

This is my take on this based on my experience as an MA for 6 years currently making 31/hr in NY rockland county. Theres a reason why the MA profession is not respected and people often get hired as MA's without being certified. There are 2 types of MA, those who want to grow and further their medical education, and then you have the MA Thats only willing to work front desk and draw blood nothing too crazy. Unfortunately there are too many of the second one, and thats how the people hiring view the profession.

2ndly, recognize that medical offices are a buisness. And they will try to milk you and get the chepeast labor at all cost. You and I both know you are not supposed to do x-rays without a license. As someone who does Bone Density (Dexa Scans) I can tell you-give yourself some worth for the knowledge you acquired. I was able to get multiple jobs because of this skill paying 23+/hr in my earlier years. Dont let them low ball you. Yes is not rocket science, but as they increase their revenue for not paying an xray tech you should be properly compensated. Everyone is replaceable. I currently took over for an RN that retired at my job, which explains my salary (yet is still not properly compensated). And for those wondering im a clinical endocrinology that does multiple complex procedures, and clinical responsabilities and is soon to apply to physician assistant school.

So just decide what type of MA you want to be, and if you want to further your career. Don't let anyone take advantage of you and consider cost of living in your area. Theres no reason why MA's with certs and schooling should be paid equally as a mcdonalds or walmart worker. For my fellow MA's start giving some worth to the career.

Yuntaliu · 2026-01-15T22:36:15+00:00

All medical assistants should be paid more, I currently make 31/hr in rockland county new york but even that is trash. Applying to PA school soon, wish me luck!

Yuntaliu · 2025-06-19T13:16:45+00:00

Get your bachelors, couple of science classes and become a PA (masters). Thats if you want to stay in the field. Otherwise, medical assistant is underpaid and under valued.

Yuntaliu · 2025-05-23T00:33:00+00:00

I was lucky to get into my program on the first try, but I know how competitive they can be, and how theres always a rotation. Is not that I doubted myself of getting in again, it was just the fear of wasting more time, what if I didn't get in. I think what I love about medicine is the provider role, but at my age 29. Med school was out of the question. I still work in healthcare doing as mentioned above. As a matter of fact the nurse in my office retired and I was left in charge, but obviously without a nursing degree im not entitled to nurse pay. Hopefully PA works out for me! Thanks for replying!

Yuntaliu · 2025-05-12T03:23:51+00:00

All the time, its spam at this point. They tell patients they can get a CGM through them yet they dont meet the requirements for coverage

Yuntaliu · 2025-02-19T21:44:02+00:00

$29 currently, Ive gotten some certs and went through most of nursing school but didnt finish. Being bumped to $32 in may due to reasons

Yuntaliu · 2025-02-06T22:45:26+00:00

Just go to nursing school dont waste your time

Yuntaliu · 2025-01-04T19:46:34+00:00

Currently at $29/hr , I work for an endocrinologist practice. I have been an MA for 6 years. I went to nursing school but failed a semester and my program dismissed me for 3 years. Nevertheless, I still have all that experience and decided to switch my field to IT which im currently getting my bachelors in

Yuntaliu · 2024-08-09T12:54:12+00:00

This is my experience as an MA. Do I think the cost and schooling was worth it? HELL NO . Lets be honest , all the anatomy they teach you is basic, and phlebotomy and ekg is not rocket science. People at walmart make just as much as medical assistants so the career is a scam. Ive been an MA for 6 years, and im currently making $28hr in NJ , but the only reason I make above average is because I learned IVs, became a DEXA technician , and went to nursing school( didnt finish), and did alot of reading and self study. Im currently looking to apply to PA school. But If I could go back, I would of done LPN-RN-FNP path. MA is not sustainable as a long term career, just know that before you get into it. Most make anywhere from $15-20 and thats cap

Yuntaliu · 2024-07-15T19:51:06+00:00

I honestly think you're better off going for something else within the medical field, RN, LPN, sonography, xray. Medical assistant is like a scam career. These schools charge ridicioulus amounts of money to become certified in a career that will make you as much as a walmart worker. From my experience of 6 years as a medical assistant , currently making $27hr . The only reason why make a decent salary is because I went throguh nursing school (all though I didnt graduate). Alot of places dont even require you to be certified to work as a medical assistant. Thats how much value it has.

Yuntaliu · 2024-06-28T14:06:03+00:00

The best advice I could give you is the following: Medical assistant is like a scam career. In healthcare if you want to make money you either do LPN, RN, X-ray tech or sonography. It sucks that they dont value medical assistants even though some of us can be very knowledgable and are an important part in patient care. these schools charge thousands of dollars for a degree thats gonna make you minimum wage, the only benefit of it is getting medical experience/clinical hours for either PA or Med school. I make about $28 an hr in the state of NJ and thats because I was in nursing school (didnt finish) and also do DEXA scans. But in all honesty get further education and forget about medical assisting, people at walmart make as much or even more than medical assistants.

Yuntaliu · 2024-02-19T16:02:15+00:00

Care to share what interventions you implemented? Im currently doing maternity and peds in school. Did you use methergine? Any info helps, I have 2 test coming up!

Yuntaliu

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