Doctor writes a scathing open letter to health insurance company.
View Reddit by puzzledplatypus – View Source
View Reddit by puzzledplatypus – View Source
Doctor writes a scathing open letter to health insurance company.
View Reddit by puzzledplatypus – View Source
We need more healthcare workers and physicians like this.
I was told a dental crown on a broken tooth wasn’t repairable after the dentist repaired it. Then they said the buildup wasn’t required. The office had to write two letters and send xrays. This is part of the reason our system is broken.
Id have this individual as my physician any day . As an aside, yes that ins company sucks. I’ve dealt with them .
I feel that pain. Fought for months with insurance to have an antidepressant covered. They wanted me to try at least 3 others before they would even consider it. Funny thing is, I have already tried 6 others, and they should know because they covered it. So after months of back and forth between me, doc, and insurance, they finally consented to extending coverage to this medication. The covered amount? $.01. One fucking cent. I have since given up on trying to take care of my mental health. It’s obvious that an accountant with no medical training of any kind knows better than my doctor.
And let’s not forget stupid shit like being told 150mg prescription isn’t covered, but 2 x 75mg is. There’s no difference except extra work for me, the doctor, and the pharmacy.
When anti-Medicare-for-all people say they don’t want bureaucrats rationing their care, show them this. Shit, care is rationed TODAY by bureaucrats. But the goal of these bureaucrats is to deny as many claims as possible. And we all pay our own money for the privilege of this.
By the way, United Healthcare makes about 18B in profit. What if we just…didn’t pay that extra $18B for shit service? Might as well get shit service at no profit.
Have people started talking more about the american healthcare system recently or have I just started noticing it now?
Had a friend get an authorization letter for his 2nd varicose vein surgery on the other leg, did the surgery then the POS insurance company denied the coverage saying the letter was not binding. They paid for the first one fine. He gets a bill for $12,000. My SIL is an insurance attorney and I offered him her contact info. Never followed up with her. This is what drives her to be in that profession. The dinner time stories are amazing to hear and sometimes quite infuriating. My wife’s co-workers daughter got hit walking on the sidewalk by an insured driver. Insurance company denied coverage. The girl had brain damage among other things. My wife tells her dad about it who has an insurance law firm. Things changed in a big hurry in favor of the girl at that point and got a reasonable settlement. They are fuckers
My roommate had to drive himself to the er because his appendix burst. He had to fight insurance because they claimed the procedure wasn’t required. My friend almost died and the insurance wouldn’t pay because “it wasn’t a required operation”. Insurance can be such a scam where they try to get away without paying.
I have this exact insurance. They wouldn’t cover a monthly prescription of progesterone so I didn’t miscarry my son. $300 a month. I literally went from having a nice savings cushion at 7 weeks pregnant to picking change out of my couch cushions to pay for the medicine by his birth.
The entire system is criminal.
I had a 7mm kidney stone lodged in my ureter tube and the pain was so bad I was going numb in my extremities as I came into the ER….for the second time while I was waiting for the insurance to approve my lithotripsy.
They denied one of the tending physicians because of the network even though the ER visit was covered under the emergent clause, so I kept getting paperwork from the insurance over the denial of an $1100 bill. Still getting that paperwork 6 months later (no bill though, I think they’re billing the insurance repeatedly so it’s a matter of time before it hits me).
Then the insurance denied the facility my urologist was operating out of for network reasons and *I* had to call them and get a list of facilities and then coordinate with the doctor’s office to find one that overlapped (the office’s scheduler was to blame for this as well) so it took 2 weeks and tons of phone calls to get it lined up finally, all while I couldn’t even sit still from the agonizing pain. Oh yeah, and it still ran me $6000 after deductible and OOPM.
I have other issues I’m putting off because I’m still paying that $6k off and I have to get ready to do it all over again.
Fuck the American Healthcare system and especially fuck the pharmaceutical and health insurance companies.
I remember when Obama was trying to push healthcare the R kept going on about death panels in socialised healthcare. Insurance Companies and their execs are literal death panels. It’s a pity he didn’t make a real push to reform healthcare though.
Yeah, I converted my business to a cash (no insurance) practice after getting tired of the games. I billed one company and got denied, provided all the requested documentation justifying the visits, records showing the patient’s progress/improvement, and then somehow they whittled the charges down to what they thought was fair: two separate checks for $0.75 each. 75 goddamn cents?! That’s less than the fucking stamp they used to mail the check! Bastards. Nope. That broke me. I walked away and have never looked back.
Fuck insurance companies. I had to sit around for a month with a broken finger because of bureaucratic garbage. I’m still trying to get full mobility back from having a broken finger immobilized in a splint for far too long.
We need to hold corporate management accountable.
http://www.reddit.com/r/notakingpledge
As long as the healthcare system is for-profit, this will continue indefinitely.
A few years ago I had a billing issue with a third party physicians company. The hospital contracted with this physicians group and while the hospital did accept our insurance, the physicians did not. I got a huge bill and they refused to work with the insurance and refused to give me a cash discount. I read the biography of the CEO and he stated that he started the company to put patient needs first, we’re healers first and a business second, we’re going to be transparent and make things easy, etc.
I wrote him a letter and shared my experience and said that I found the hospital accepted insurance but they didn’t, there was no way for me to know this would happen, now I’m stuck with a bill I can’t afford. I closed by telling him his company became everything that he built it not to be and he failed in his mission.
He called me back personally a few days later and apologized to me and said my comments hurt him. I’m sure they didn’t change anything, but they ended up accepting a coverage proposal from my insurance.
Insurance coverage and billing and healthcare costs are just a shit show in this country.
As a pharmacy technician who often has to tell people that their insurance has stopped paying for the medication, I’m tempted to write my own letter. One time there was this old woman who agreed to pay 400$ for her insulin and she just had no choice but to pay for it. It’s a pretty common thing in the pharmacy and my stomach turns every time it happens.
It’s even worse when a patient goes apeshit on you. I’m just the messenger boy, direct your frustration to the money-sucking insurance corporations or better yet, the politicians that allow this.
My wife was seeing a medical specialist, who’s a true leader in his specific field. He essentially had the same comment and was clearly frustrated by the insurance companies as well. He said it’s so refreshing to have 22 year old claims processors tell him what should and shouldn’t be acceptable treatments for patients. It really is a Seinfeld episode.
I’ve twice had my physician send a letter to United Healthcare because they wouldn’t cover an “unproven procedure” that’s, well, proven.
I have to write a letter to BCBS and argue that my follow-up visit for a cancer surgery was in fact necessary. Wish me luck!
My wife had shoulder surgery a while back. In the beginning we weren’t sure if she needed surgery or if it could be rehabbed. The doctor said he wanted an MRI done to evaluate the damage to confirm everything. Doctor sent off for an MRI that insurance promptly denied. Made us jump through several other procedures that we of course had to pay co-pays for and none of it helped and her condition deteriorated. About a year later, just as I am about to make the call to just pay out of pocket for the MRI, insurance finally approves it. When the results came in, the doctor basically said that her shoulder has deteriorated to the point that surgery is unavoidable and believes she could have avoided it if she could have started the proper physical therapy a year prior.
Insurance basically covered the entire procedure though, so I guess that was nice
I worked for a health insurance company in Arizona 20 years ago as an IT contractor. the amount of times I overheard the words “we can deny coverage,” was astounding. The most senior folks were MDs who sold their soul to stop practicing and just work for them to deny coverage to people who desperately needed it. Despicable. I’m not proud of that job.
My “insurance” that I pay $400 a month for won’t cover the heart medication that the doctor they sent me to said I have to have or I would just end up back in the hospital again.
The only dentist they would cover said I needed to have my wisdom teeth out, they ok’d it, I had them pulled, they then denied the claim saying they wouldn’t cover it. I still have the letter stating they would cover it which I took with me to get them pulled. The place that pulled them then sent creditors calling ten times a day & eventually, the actual local police showed up at my door with a summons to pay or appear in court.
Just recently paid off an MRI (for my wife) that like above, the doctor said was required, got “approved” by the insurance company, took the letter to the office, got the MRI & a few days later received a letter from them saying they wouldn’t cover & one from the office saying the insurance had declined it and I had to pay or be sent to collections.
I am sure most of us could list things like this, along with medications that are insanely priced. Pay or die, or end up in the hospital with huge bills & missed work. The entire system is a scam, we are the only “first world” country without medical coverage, we spend the most & have some of the worst healthcare in the world. [The U.S. ranks LAST overall on the health care outcomes.](https://www.citizen.org/article/dead-last-u-s-health-care-system-continues-to-rank-behind-other-industrialized-countries/)
[US ranks LAST in healthcare among 11 wealthiest countries despite spending most](https://www.theguardian.com/us-news/2021/aug/05/us-healthcare-system-ranks-last-11-wealthiest-countries)
US spends 17% of GDP on healthcare but struggles with affordability and has the most administrative hurdles
I don’t understand why Americans keep putting up with this when every other civilized country has universal healthcare? As a Canadian it’s hard not to notice that the plot of half the movies I watch involves people needing to commit crimes because they can’t afford health insurance. It’s just insane that if you get cancer or some other serious disease you can apparently go bankrupt? Just because you’re sick? Absolute madness.
I used to work for this company. I would spend a lot of time in executive conferences and presentations with high level executives.
They’re all aware at how broken the whole system is, but only the solutions that provided monetary benefit would even be considered. Even if they didn’t really address the actual issue.
PSA: United Healthcare is the worst commercial insurance plan for both patients and providers.
I needed heart surgery for a cyst the size of 2 coke cans in my chest – the insurance company decided heart surgery was an outpatient procedure and I could just walk out of the OR instead of going to intensive care. They even wheeled out a company doctor on their payroll that said as much.
In the end the hospital had to (on paper) wheel my unconscious ass out the door, over to the ER, admit me and send me to intensive care to recover since I had the unfortunate condition of having my chest cut open and 4 drainage tubes in me and needing oxygen.
I am pissed at insurance company right now because my dad has to wait on them to approve immunotherapy treatment for his liver cancer. The last time the insurance company rucking around for a month to approve his Hep C medicine which caused his liver cancer and now we got word that if nothing is done my dad is dead in six month. I hate our healthcare system.
friend´s mom was a neurologist and there was reason to suspect the patient had a mass in his brain. The ONLY mass in a brain is a tumor and those things you don´t mess with. Friend spent hours on the phone arguing with insurance because they were refusing to cover a basic scan since they deemed it “unnecessary”. If you want to see a major cause of physician burn out, check the insurance
I had a professor say that the insurance business model is:
Step 1- get the money
Step 2- keep the money
I broke my wrists in college (circa 1999) and had surgery pre-authorized to be done by a French Canadian hand surgeon named Michel Benoit. Pronounced Me-shell Ben-wah and not Myk-all Bah-noyt.
Afterwards, insurance refused to pay the $6000 bill and said it wasn’t pre-approved.
I will never forget hearing my mom yell into the phone: “HIS NAME IS ME-SHELL. HE’S A MAN! HE’S FRENCH CANADIAN!”
Apparently after weeks of back and forths, someone finally told my mom (in a very confident tone) that a woman named Me-shell Ben-wah was not in-network and only a man named Myk-all Bah-noyt was pre-approved to do the surgery.
Transcription error almost cost me that semester’s tuition. Insurance sent us a fruit basket with an apology note.
Insurance has always been an unnecessary profit taker that just stands between patients and their treatment.
Had a coworker who gave birth to twins. She tried to add her children to her health insurance plan. Insurance kept denying one of them, and she called regularly to get them both added. Insurance company rep on the phone: “Are you sure you had two?”
The fact that people in the insurance industry can deny healthcare by means of refusing financial assistance when they are not doctors is beyond bullshit. It should literally be a crime, because if you try to practice medicine without being licensed in the United States, that is a crime.
Every healthcare CEO should be in prison
As a physician in the USA, this is one of the primary causes of “burnout”. From our broken education system putting us in $350k debt so that we can actually help people, to the 80+ hour work weeks of residency at minimum wage which deprives us of our 20s and most opportunities to be with friends or build a family…. once we start finally practicing, insurance and admins are breathing down our necks trying to suck our teets dry of any and all capital.
I just wanted to help people and make a difference.