Earlier quoted context omitted.
The point was there’s a lot of people with a lot of transactions in healthcare happening, so “hearing” about it constantly doesn’t mean anything. And yes, I know the link doesn’t have statistics in erroneous denials of coverage (I couldn’t find it anywhere quickly), but it did note that the law requires insurers to abide by an external reviewer’s decision. Surely if there were that many erroneous denials of coverage,…
I agree that there would be plenty of horror stories to fill the news, even if such events were extremely rare, but multiplied by 300 million. However, many people's "hearing" is a slightly less biased sample than that. It's that every American they have personally talked to about any visit to a hospital seems to have a horror story about (at very least) crazy bills, hours on the phone with insurers for months to yea…
> We don't get this nonsense where the insurer tries to deny us and hope that we don't dispute.
Restated, this is claiming that health insurers in the US erroneously deny coverage as a policy. And that is the specific statement I am saying is untrue.
The crazy bills are true, you should of course budget to be able to afford the out of pocket maximum for healthcare costs in any given year. The hours on the phone might also be true, but I know how complicated of a topic US healthcare is (perhaps needlessly, but it is what it is).
Personally, I have more issues with the healthcare providers than with the insurance companies. The insurance company has picked the phone pretty quickly when I call, and tell me the price of a procedure they have negotiated with the provider if I give them the code for it. You can even search it online on a map to shop around the prices.
The problem that I have in US healthcare is that no healthcare provider is willing to give me a code, even for simple checkups or X-rays or what have you, where everything is known in advance. The healthcare providers don't want to risk
And to finish, I'll provide with an anecdote about one of my experiences with healthcare:
My wife gets an ultrasound. The healthcare provider charges $15 for "towels" used to clean up the gel they put on my wife for the ultrasound. In reality, it was a few pieces of paper towel. The insurance company denies to pay for the towels, so we get a bill for $15. I call the healthcare provider and asked why I'm being charged $15 for a few pieces of paper towels. The person in the billing department says to ignore the bill and not pay it.
As a consumer, what am I to understand here? That healthcare providers are overcharging? Or maybe insurers are underpaying (or paying late, or causing too much paperwork) so that healthcare providers are overcharging to make up for some of that? Or healthcare provider is just charging and collecting payment from anyone who doesn't contest, and letting it go for anyone who does?
I inquired multiple times as to all the charges that will be had during the ultrasound. It's a completely routine procedure with no unexpected costs, but the healthcare provider told me they can't give me the codes they will bill. Had I been provided the codes beforehand, I would have brought my own paper towels to wipe the gel off. So I can conclude that the healthcare provider was not really trying to recoup paper towel costs.