Doctors are also seeing previously approve treatment later disapproved by an insurance company and a demand for payment to be returned.
The flip side of this is that there’s a reason why the only medical procedures that decline in cost over time have been the ones that insurers don’t cover. It’s amazing how economical medical procedures get when they are discretionary and people pay for them out of their own pockets. I’ll cite laser eye surgery and cosmetic surgery as two examples of this.
This is one of dozens of reasons many insurance companies have less-than-ideal reputations. It’s not just health insurance.
My auto insurance company took 4 months AFTER my stolen truck was recovered to make a decision whether to repair it or just pay me out. The truck’s value dropped by near half during their dilly-dallying. The worst part is that there had been as much maintenance work done on the truck in the previous year as they paid out for the total loss. In fact, three weeks before the theft, the whole suspension had just been redone to factory specs, and the steering box had just been replaced, with a new turbo housing as well. That alone had cost 2/3 of what was paid by the insurance company for the loss. It also had only 8K miles on a new set of Toyo M-55’s all round.
I LOATHE all insurance companies. They’re more than happy to take your premiums, but heaven forbid you actually have a claim, because they will move heaven and earth to avoid paying out one thin dime.
Yes insurance does deny care, humana and united Healthcare. I heard the phone calls for reviews.
The US “insurance system” will not survive 5 years. Medical services economics are in a death spiral.
I am a humorous example of this prior auth stupidity. My doctor has prescribed a medicine for me that is on a controlled substance list. The max prescription is a 30 day supply. My insurance requires mail order after three fills. But they also would not approve the 30 fill under this prior auth crap. And they insisted on faxing the forms to the doctor instead of allowing email or some web page.
This drug costs about a penny a pill. And they were refusing to approve a 30 day fill. But they were happy to allow a seven day supply.
So for the last four months I have had to go to the mail-order pharmacy’s website every week to “refill” my seven day supply so they could mail me seven pills and charge me nine cents. Their stupid slow-marching of this prior auth is costing them the price of postage minus the nine cents they have been billing me.
They finally came to their senses last week and approved the prior auth. Now they get to bill me 39 cents for 30 pills.
If they pull this crap over pennies, it is not a surprise they also pull this crap over something costing thousands.
They don’t give a crap about our lives or health, only about their profits, which in more and more cases will be higher with us dead, as we are cost centers.
I think this is a First Amendment issue.
So just have at it. (And none of that “pistols at dawn” nonsense.)
I see the problem being that people with a BA in accounting are making medical decisions.