I Set Out to Create a Simple Map for How to Appeal Your Insurance Denial. Instead, I Found a Mind-Boggling Labyrinth.
I Set Out to Create a Simple Map for How to Appeal Your Insurance Denial. Instead, I Found a Mind-Boggling Labyrinth.
I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals. Nearly everyone said the same thing: Great idea. But almost impossible to do.
profiting off of health care is immoral. so disappointed that the USA can't figure this shit out
I don't mind nurses and doctors making enough to live a nice life because it will ensure we have enough nurses and doctors in the future.
What I mind is people who provide no benefit to patients sitting between them and the care providers, taking a cut off the top for doing fuck all.
Every time I see an advertisement for health insurance I wonder who got their coverage denied to pay for it.
ETA: I finished the article and this is the worst part of it:
Dr. Christianne Heck, a neurologist specializing in epilepsy with Keck Medicine of the University of Southern California, said her health system has a team of professionals dedicated to appealing denials
So we've got a team of highly educated and motivated people whose sole job is to help people appeal denials to health care that medical professionals have advised.
What a tremendous waste of human talent. All of those people could be working to care for people, or building something useful. Instead we waste millions of dollars and entire human lives fighting against an impenetrable system designed to prevent health care from happening.
What a fucking stupid country.
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I mind, because each and every doctor I've seen regarding my chronic pain I've been dealing with for over 5 years has refused to diagnose me, and every appointment I've been recommended anti-depressants and anti-anxiety medication, which are not solutions.
From my perspective, most doctors don't seem to do shit, they just listen and try to sell the trendiest, most profitable drug for Big Pharma. If I could find an actual, legitimate doctor, maybe my opinion would change, but I've been left to suffer by the only people that are supposed to be able to help. It's gotten bad enough to where I went to an emergency room, and they still did nothing, except try to prescribe more drugs.
I see it as a huge scam. A major scheme. It doesn't seem to just be insurance companies, but even the doctors themselves seem to be full of shit.
If you want to get mad and simultaneously have your mind blown, read Bullshit Jobs. The last chapter in particular has a decent chunk dedicated to why the state refuses to change the way our healthcare system works outside of "because it makes the rich richer". David Graeber's work has only become more true in the years succeeding
Oh, the wealthy in the US have it figured out perfectly.
--checks laws for morality clauses--
huh looks like that doesn't actually matter. Surely you meant profitability
/s
In the context of insurance, absolutely.
When it comes to health care delivery (clinics, hospitals, etc), you have to define more of what you mean. These places need to make a little money on the care they provide because they need to buy new equipment when the old stuff dies, fix the roof, repair stuff, etc. If those places are not making a profit, they will eventually die.
Now if you mean a profit that goes to anything but maintaining the ability to deliver care (e.g. shareholders), that is despicable. There is no place for shareholders in a healthcare company.
That is why Medicare can administer funds cheaper than an insurance company. No shareholders!
Insurance is a huge scam. I hate it.
For starters, she said bluntly, “we know everything is going to get denied.” It’s almost a given, she said, that the insurer will lose the first batch of records. “We often have to send records two or three times before they finally admit they actually received them. … They play all of these kinds of delaying games.”
Fucking evil. We need health care reform now. You can't morally justify playing with people's lives like this. The suits running investment firms that own the hospitals and the suits running the insurance companies will keep cancer treatment from a child because they want to spend their winters in Tahiti and their summers in Patagonia. We have to make this stop.
This happened to me twice. First, when I applied for long-term disability insurance through the insurer that my employer used. Second, when I applied for SSDI.
I am convinced that there is a policy of "losing" or "not receiving" documentation in order to discourage the patient from continuing to pursue their claim.
I have only managed to succeed because I retained an attorney (two, actually--one for the private insurance and one for SSDI). As a disabled person with limited ability to handle these things myself, I never would have been able to win the insurance money that I deserved. As the system intends.
An insurance's purpose is to cover you for unpredictable circumstance
A for profit insurance's job is to not pay you for as long as inhumanely possible
But you have to have insurance because the alternative is financial ruin, even if you could still be financially ruined either way.Yeah. In case anyone was wondering, the down payment on a surgery to remove a cancerous tumor near your heart is $100,000. Cash, or no surgery for you. The tumor is growing fast, so you only have a few days to come up with the money.
That's all because the insurance company said the surgery wasn't necessary. Or maybe it was too experimental. I forget. Some family members with high paying jobs managed to come up with the money, and my uncle got to live a few more years. I'm sure not everyone is that lucky. And why on God's green earth should it have to come down to luck?
Insurance changed their mind after a long appeal. I think it took 1-2 years.
Insurance is for something that might happen. Everyone will experience health problems. It's a contradictory situation at its very core.