41–50 of 354 posts
Earlier quoted context omitted.
So what should happen when Docs lie about what procedures they did? Because it happens quite frequently and for some reason is always left out of these discussions.
Man, it's almost like healthcare and human lives shouldn't be for profit...
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It's beyond our control, says only country where this happens daily.
Pretty sure fraudulent billing practices exist in a variety of nations and industries.
And having lived 10 years in Canada and 10 years in the US and used both their healthcare systems quite a bit, I have seen both sides. Let me just say I moved to the US for healthcare 10 years ago and we do not regret it one bit. The US is easy to point and laugh at, but that just comes from ignorance.
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It's beyond our control, says only country where this happens daily.
IT is beyond our control because we have setup a system where the people who are paying don't want to control things. My boss wants insurance to be expensive - if I could afford it I would be more willing to quit (retire early). Finding cheaper services isn't in my interest - I'm not paying any bills anyway. Insurance companies like the complexity because it means I can't understand the system and so I have to use th…
Earlier quoted context omitted.
Man, it's almost like healthcare and human lives shouldn't be for profit...
Find some doctors, nurses, researchers, manufacturers etc etc who will work for no money and we can remove money from the problem.
Not being for profit doesn't mean you don't pay people.
Further, I wonder how the Sixth Amendment works then? So many non-profit people working for... no money?
This "work for no money argument" is so incredibly weak, I had to make sure I quoted the argument so the person wouldn't change it.
Earlier quoted context omitted.
Man, it's almost like healthcare and human lives shouldn't be for profit...
"It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest."
On the opacity, I have one informative anecdote. I had a single blood test done awhile back and no one knew if insurance would cover it, or which of the dozen or so billing codes it involved (taking the sample, delivering the sample, testing the sample, etc.) might be covered. It was an expensive test so I spent days bouncing between the doctor's billing team and the insurance company until the settled answer was: No one knows, do the test and insurance will decide. So I did it and insurance denied covering the doctor-recommended test. The salaries involved for all the billing people (and my time) would have covered the cost of the test.
Good startup idea would be to work with medical practices to use AI to automate the disputing of the "downcoding" by insurers.
I wonder what would happen if we moved the "medically necessary" requirement burden of proof from the doctor/patient to the insurer. So the insurer would be required to pay out a claim regardless of whether the insurer thought it was medically necessary, but their recourse could be to try to claw it back post-payment.
Earlier quoted context omitted.
"It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest."
Exactly. Glad you agree it shouldn't be for profit, either.
Earlier quoted context omitted.
So what should happen when Docs lie about what procedures they did? Because it happens quite frequently and for some reason is always left out of these discussions.
Man, it's almost like healthcare and human lives shouldn't be for profit...