Microblog Memes

I really believe a lot of this comes down to poorly automated systems and people not allowed to go off script … and insurers have no reason to change this.

When there’s a claim it gets entered into the insurer system by procedure code. It’s only decided based on what procedure code is recognized by the system. The peon deciding to reject it likely has no power to say otherwise nor incentive to. Even when they do ask for a doctors opinion, do you really think he reads all the case notes, or even has access to them, or has time to read them, or incentive? Nope, just whatever codes were entered into the system. You read a lot about issues where procedures have to be recoded for insurance, but I’ll bet many more of the rejects are as simple as the code not supporting the treatment and no one at the insurer looking farther. This is more a form of institutional incompetence but insurers have a profit motive in maintaining this incompetence

Also, there's this common "feature":

Dr: "You need this procedure."

Me: "How much will it cost me?"

Office Manager: "I won't know until I bill your insurance and find out if it is covered."

Me: "What is the cash price I would pay you if it isn't covered by insurance."

Office Manager: "I have no idea."

This shit really needs to end.

I had a friend who needed a CT head, chest and abdomen. The insurance company decided she could have the head and abdomen, but not the chest, and couldn't really explain why when asked. American health care is a joke.

The cruelty of the US American for-profit health system is what should be uniting all US Americans in protest, riot, and violent overthrow of the current system.

I work for a neurologist practice, and the amount I have to argue with insurance (and inevitably have to get the neurologist on the phone to directly request something for many) is insane. A good chunk of my job isn't providing care, but arguing with insurance that the care is necessary. These companies are actively delaying patient care, and try to blame the physician whenever possible.

Wildly infuriating, especially when the denials are worded along the lines of "we reviewed this, and don't consider it medically necessary". Motherfucker, a doctor said it was necessary and listed the clinical reasons why this test or procedure would be beneficial. Nothing has radicalized me for universal healthcare more than working in healthcare.

Had my buddy over who brought over his incredibly questionable 30yo brother who shared some real incel levels of talk. He used my bathroom and asked if I wore tampons since a pack was visible. Like bro, I have a wife and a daughter.

Anyways, that guy works in health insurance!

I don't know how much decisions he can actually make. But that dude has a middle-school level education about sex ed and struggled to explain what a period is. And he is one of the barriers to approving/rejecting your health care.

I love how the insurance company, the party that has no medical expertise whatsoever, gets to unilaterally decide how much that MRI will cost you today.

Yes I would like to change this, too. Who do I vote for to make this happen? Just kidding I don't have access to $10B of "free speech."

The private for profit health insurance industry - because what could make number go up better than a (LEGALLY MANDATED) do nothing middle man who's only purpose is to take your money and ensure as little as possible is spent on healthcare sitting between you and not dying?