Best healthcare system in the world (for stockholders):
Doctors, patients try to shame insurers online to reverse previous authorization denials
“They take in premiums and don’t pay claims. That’s how they make money. They just delay and delay and delay until you die. And you’re absolutely helpless as a patient.”
I had a 50ish patient with new acute #backpain superimposed on, but different from, long-standing chronic back pain. On #history and #exam they had NEW lower extremity neurologic findings. I ordered an #MRI, which was the appropriate next step at the time.
I was forced to spend two evenings on hold for something like 20-30min for "pre-authorization"… two because they hung up on me the first time. I had to re-type a 20 digit code three times as they redirected me internally… finally spoke to the "physician in authority" and… HE READ MY OWN CHART BACK TO ME!! … then blithely approved the study. <insert swear words here!>
This is my Exhibit A for #HealthInsurance#malfeasance. (A complete waste of my time and that was the point! Unethical, and should be illegal.) Ironically I had a very conservative approach to imaging. That was probably the first new study I had ordered for back pain in months.
@richardrathe@rvaughnmd For me, it took my family doctor 4 times to order an MRI before insurance approved it. In SIX months! I went on the warpath with my insurance company for THEM to fix it. Pointed out I’ve now had a total of 7 ER trips and maybe since they’ve now paid out $30k it would be smart to approve MRI at $400. They claim it’s the fault of a new, 3rd party used for all pre-authorizations for anyone with Medicare or Medicaid. This is political change to require 3rd party approval.
@rvaughnmd I'm actually on hold with our insurance right now while they yell at the ER physicians for ignoring the explanation of benefits they've faxed over twice for what's supposed to be only a $50 bill instead of $250. This is on top of the $604 I already paid for the ER visit itself--JUST THE PHYSICAL ROOM--for a 2 hour ER visit in APRIL. Our insurance was actually pretty responsive in this case...the issue is the providers themselves. Apparently when we went to the ER, because it was for my 5 year old who was screaming in pain from thhe back of his head (which he had bonked a few days earlier, so I had no idea if it was a delayed concussion, meningitis, what...and of course the after-hours nurse had advised taking him to the ER "just in case" because that's what she ALWAYS does), they put us in a "level three" room, basically put us in a room almost immediately instead of having us wait in the lobby with the other people waiting (but no doctor actually came into the room to see us for at least a half hour anyway), but then decided it wasn't an "emergency" (they decided it was an ear infection, though again, screaming child out of nowhere that said the back of his head hurt, not his ear, so how am I supposed to know this??) so they charged us for the most expensive room, but then charged us for a non-emergency, so we literally had to pay the max amount that they could have charged us.
I hate this country so much. Just like the gun lobby, politicians are paid very well to let the "health" insurance companies run absolutely amok.
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