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Feds help health insurers hide their dirty secret: denials on the rise

nypost.com

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Re: Feds help health insurers hide their dirty secret: denials on the rise

#91

Post by harshaw »

garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

They should make anyone who denies anesthesia for a colonoscopy drink that awful orange flavored drink you take the night before. This is just like... basic care.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#92

Post by devilbunny »

garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

I'm an anesthesiologist. What they denied was paying me to do it. You can still get "moderate sedation" from a nurse - a benzodiazepine and opioid.

Patients strongly prefer having what amounts to a general anesthetic; your chances of recalling anything are low either way, but propofol results in a much faster recovery to full consciousness afterward.

Go gain 100 pounds and develop sleep apnea. Then they'll approve it.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#93

Post by kstrauser »

Miner49er wrote: post #72

It shouldn't even be legal for health insurance providers to deny claims. It's essentially them practicing medicine without a license, because they're making calls about what healthcare a person needs or doesn't need, only a person's doctor(s) should be able to make those decisions.

That’s the crux of it. I didn’t visit with any of my insurer’s staff, like I did with my own doctor. How are they making treatment decisions without ever having seen the patient?

Re: Feds help health insurers hide their dirty secret: denials on the rise

#94

Post by dboreham »

Miner49er wrote: post #72

It shouldn't even be legal for health insurance providers to deny claims. It's essentially them practicing medicine without a license, because they're making calls about what healthcare a person needs or doesn't need, only a person's doctor(s) should be able to make those decisions.

Otoh some medical providers like to over bill and over treat.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#95

Post by runnr_az »

jbb67 wrote: post #77
garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

But it's not usual to have an anesthetic for a colonoscopy is it? I've had two without. I was offered a light sedation but then I couldn't have driven home afterwards. It wasn't particularly awful without. It's it usual to be asleep? I've not really heard of that. Is it a US thing?

I dunno if it's unusual? I had mine done recently, 49 years old... seemed like a given that I was going to go under? (I'm pretty sure I prefer it that way?)

Also UHC fwiw, but went through my local provider group, etc...

Re: Feds help health insurers hide their dirty secret: denials on the rise

#96

Post by tossandthrow »

xyzzy4747 wrote: post #55
tossandthrow wrote: post #36

Earlier quoted context omitted.

Why? Apparently something excused murder in the death row case? So expressing the sentiment that nothiong excuses murder and still having a death row is just I congruent and wrong.

In the death row case, the capital punishment isn't murder if you use classic definitions. If you change the definitions then it's only murder if you equate all homicide to murder. And yes, both the will of the people and tradition can justify capital punishment.

That's fair. And in that vein the current killing of the ceo can not rightfully be deemed a murder as no one have been convicted of such.

But then again, the society apparently defines the quality of a killing - only future history will tell if this is a murder, and thst can go back and forth a lot depending on public sentiment.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#97

Post by philamonster »

jbb67 wrote: post #77
garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

But it's not usual to have an anesthetic for a colonoscopy is it? I've had two without. I was offered a light sedation but then I couldn't have driven home afterwards. It wasn't particularly awful without. It's it usual to be asleep? I've not really heard of that. Is it a US thing?

I'm in US and I've had a single one. It was sedation which induces twilight sleep but I was definitely conscious. I've known many that have had them (ex-partner had stage 3 colon cancer and had/has them on the regular) and it was always sedation.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#98

Post by tedivm »

jbb67 wrote: post #77
garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

But it's not usual to have an anesthetic for a colonoscopy is it? I've had two without. I was offered a light sedation but then I couldn't have driven home afterwards. It wasn't particularly awful without. It's it usual to be asleep? I've not really heard of that. Is it a US thing?

Light sedation is anesthesia.

> Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness.

"General anesthesia" is probably what you're thinking, which is a specific form of anesthesia where someone is put to sleep.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#99

Post by OutOfHere »

refurb wrote: post #57
andrelaszlo wrote: post #2

"No industry malfeasance could ever excuse murder. Period." Murdering a murderer to save many innocents could be considered ethical by some? (Not saying that's the case here, but nypost made an interesting categorical statement.)

One issue is that if denying medical care is murder then every healthcare system is guilty. In the US it’s insurance companies (or the government through Medicare or Medicaid) but in the UK it’s NICE, in Canada it’s CADTH and the provincial health authorities. Since there are finite resources spent on healthcare, trade offs are made all the time. If spending $10M on treatment A saved 10,000 lives and $10M on treatmen…

Your argument is completely bogus for multiple reasons. Firstly, people are paying here for insurance, a lot. Secondly, it's the FDA's job to approve treatments which it does. Thirdly, we do not have a uniform privatized determination across the country of what is approvable or not by insurance companies. They deny numerous legitimate treatments and procedures at their whim.

Re: Feds help health insurers hide their dirty secret: denials on the rise

#100

Post by chefandy »

garciasn wrote: post #47

I was just denied a colonoscopy as not medically necessary by UHC, coincidentally three days before their CEO was killed, because they don't want me to have anesthesia to do it; they argue I should be awake. When I called to refute the denial, which was denied, I asked them to find the person, if it was a person, who denied it and shove a tube up their ass without anesthesia and then reassess whether it's medically n…

They found cancer in my colon during a follow-up for a ruptured appendix, several years before the age for recommended colonoscopies. I recently had one and asked they go light on the anesthesia, so I was in and out. They removed a polyp while I was awake and it was pretty uncomfortable. The idea that you shouldn’t even have that much anesthesia is insane. These people are morally bankrupt and frankly I don’t care what it takes to stop them.
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