Microblog Memes

America is one of the richest countries, but life expectancy is so low because of all these inequalities and shootings.

So here is a question:

A medical professional examined the person IN PERSON and has a requirement.

In comes the insurance to tell you your doctor is wrong and that you're perfectly fine, your doctor is basically lying to you.

Question: how the fuck did any of this ever become legal?

Had surgery to correct an underbite a few years ago after prepping for it with braces for years. For context, I was still young enough to be on my parents' insurance. The surgery involved moving my upper jaw forward and my lower jaw back because the underbite was so severe. The insurance denied the claim. My parents (I love them so much for this) decided beforehand that, if the claim and the appeal were denied, they would instead "gift" me the money out of their own retirement savings and have me pay for it. The procedure alone cost, I believe, $16k out of pocket. (I don't remember the specific reason why they gifted me the money instead of paying for it outright.)

Prior authorization should 100% be outlawed. It's either insurance adjusters practicing medicine without a license, or insurance doctors making diagnoses without examining a patient, both of which are unethical or illegal.

Though I think the real solution is a system where every time a prior authorization denial is overruled by the DOO or a court, the insurance company has to pay punitive damages of at least $200,000 to the patient.

Everyone should also remember that it's going to get worse. People, especially nurses, are leaving the medical field. GPs are becoming scarce, and boomers are taking more and more of the medical resources available as they age. It's going to get harder and harder to get timely medical care at all, let alone getting it without bankruptcy.

Think we could make Lemmy a household name by having the C suite of companies that do this SWATed? The government doesn't work so we're going to have to do this ourselves.

American health insurance in a nutshell: https://youtu.be/llx-SaGq4Fs?si=eDIny0fqcGYFkB2a

And before non-Americans ask, yes, that's actually how it is. The humor in this video isn't from exaggeration, the comedy derives from the unexpectedly clear way the absurdity of the system is explained.

They hire doctors who can't handle being practicing doctors to prop up their delusions. I've only had one on the line in a dispute and he acted quite offended when I asked for his license to prove he was a real doctor. Turns out he was barely a doctor at all. He decided instead of practicing medicine and killing people he would work for a insurance company and kill them that way.

My insurance that I pay a ridiculous sum of money for has started doing this neat new thing. When the doctor orders imaging, they mark it as “requested more information but never received any”, and reject the claim. They don’t actually request any additional information, and they ignore me when I contest their decision. So glad that I pay like $400 per month for this coverage.

No way ? insurances have a say against the word of doctors ? I must be hallucinating, I thought I knew all about it

Last time my doctor had to bill my insurance he said he would just run it immediately, because apparently "routine denial" is a thing where they just automatically deny it because if you really need it the doctor will then have his office try again with more justifications. He hated this a lot, because it basically meant he had to just assume first denial for no real reason and then his staff had to take the time to almost always go back and resubmit. He said sometimes he would submit it with the info, it would be denied, and then he would resubmit it two more times and suddenly it would be approved.

Like seriously, what the fuck. But only does that hold up necessary care, it also makes doctors do more bureaucratic work and hire more staff, which, of course, makes medicine more expensive. Brilliant.