Why do I get the impression that the representative looks something like this...
Posted on 08/08/2025 7:05:00 AM PDT by Red Badger
Insurance companies are a real problem with this.
I had a minor surgery on my face to remove a cancer.
I was approved, medicare/BCBS, for cosmetic surgery.
The surgeon was approved but her facility was not.
She did the surgery at the hospital in the OR.
United Healthcare was one of the major promoters of Obamacare.
Which made it even more expensive.................
Only one way to fix this stuff.
“Which made it even more expensive.................”
Yep. It would have been 30 minutes in her office with one assistant.
The hospital:
Checkin/prep/anesthiologist briefing
Wheeled into OR
On needle for pain
15 minutes for surgery
Dr, assistant, plus two OR staff
Post op “recovery
Almost four hours.
My sister just had pins put in her broken wrist outpatient. Book billed $43,000 in northwest Arkansas. My wife’s recent 5 day hospital Stay with two surgical procedures was $45,000 book price in Fort Smith.
Anybody want to try to explain the reason for such disparity?
I have seen youtube videos of this doctor talking about this case. She doesn’t seem like a wacko at all, but also doesn’t seem to be trying to work things out.
There is mention in the article about Medicare Advantage, and there are occasional bits of rage on FR of Advantage hatred, but I have never seen that make sense for one, overwhelming reason.
The doctors in the Advantage network are the same doctors who would provide care if a patient is Medigap. There is no difference. Same doc. Same specified care.
There ARE some rare instances where an area is so rural that there is no Advantage network so the only option in such a locale is Medigap, but this is very rare. This absolutely does not apply to this article, where this doc’s practice is no in-network because apparently United Health is trying to remove itself from that locale — which no doubt their Medigap products are ALSO trying to do.
Anyway, the Advantage hate is just uninformed. Every advisor imaginable counseling people with VA healthcare advises an Advantage plan (which is generally free monthly) for backup to VA.
The profit motive?
Medical care should be nonprofit as a service.
ANYONE who enters an operating room without authorization should be kicked out IMMEDIATELY.
I would never interrupt a surgery for a phone call. I would say I assumed it was a prank or a mistake.
This is an example of why many doctors are adopting concierge care for their practice. It is also a major reason you no longer see doctors in solo practice but as part of a group under the control of the hospital.
“Gaffney, who did not speak specifically about Potter’s case but the industry in general, said that part of health insurers’ jobs is to prevent unnecessary care as a way to counter the exorbitant cost of health care in the U.S., from pricey drugs to expensive hospital stays.”
Wrong the health insurers’ job is to make sure it can show a profit to its investors. It is a business. To them unnecessary care is not care that is not medically warranted but care that threatens their bottom line. If it was about protecting the patient there would be no need for contracts spelling out just what they will or won’t allow. You would pay your premium and deductible and they would cover percentage of the bill agreed upon.
Have your sister check the codes used for the procedure and the diagnosis.
True but it was the call from the agent that came through not the agent herself.
Why? Why shouldn’t a doctor providing medical care make a living from it? There is nothing wrong with for profit medical care. The problem is with just how many indirectly involved persons expect to be profiting from it. At the expense of the patients and direct care providers.
I sense a lack of business acumen here: taking out a $3.5 million loan to get her practice started?
I once had an insurance company send me a letter signed by their medical Director saying they were denying coverage for my legend blood pressure medication because I had not tried other cheaper drugs in the same class. I was very tempted to bring a malpractice claim against the medical director since he was making a diagnosis and prescribing medication without ever seeing me as a patient.
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