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"Not Medically Necessary": Helping America's Health Insurers Deny Coverage

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71–80 of 224 posts

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#71

“The algorithm cannot say no, however. If it finds problems, it sends the request for review to a team of in-house nurses and doctors who consult company medical guidelines. Only doctors can issue a final denial.” As a physician, I’ve had to speak to these so called “peers” in a peer to peer denials with both my clinic and hospital setting. They are usually people who aren’t physicians as a first line of their defens…

I’ve saved a message that was reposted by Bill Ackman on dealing with denials. Thankfully, never had occasion to use it yet:

>> So, your doctor ordered a test or treatment and your insurance company denied it. That is a typical cost saving method.

OK, here is what you do:

1. Call the insurance company and tell them you want to speak with the "HIPAA Compliance/Privacy Officer" (By federal law, they have to have one)

2. Then ask them for the NAMES as well as CREDENTIALS of every person accessing your record to make that decision of denial.

By law you have a right to that information.

3. They will almost always reverse the decision very shortly rather than admit that the committee is made of low paid HS graduates, looking at "criteria words." making the medical decision to deny your care. Even in the rare case it is made by medical personnel, it is unlikely that it is made by a board certified doctor in that specialty and they DO NOT WANT YOU TO KNOW THIS!!

4. Any refusal should be reported to the US Office of Civil Rights (http://OCR.gov) as a HIPAA violation.

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#72

“The algorithm cannot say no, however. If it finds problems, it sends the request for review to a team of in-house nurses and doctors who consult company medical guidelines. Only doctors can issue a final denial.” As a physician, I’ve had to speak to these so called “peers” in a peer to peer denials with both my clinic and hospital setting. They are usually people who aren’t physicians as a first line of their defens…

As a random person, I'm becoming convinced that the first stone to get things rolling is full price transparency at all scales.

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#74
post #43
post #30

The worst part, simultaneously soul crushing and apocalyptic rage inducing is that we get these outcomes after spending more per capita on healthcare than pretty much any country on the planet.

... and that money isn't going to insurers.

... nor the providers.

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#76

Earlier quoted context omitted.

Every other country seems to solve it

[flagged]

I live in Québec, Canada and the longest I had to wait was 3 months for a gallbladder ablation. And my wife, who is on her fourtht year of ribociclib to prevent her spinal metastasis (breast cancer) from coming back, have timely periodical CT-PET and IRM scans.

MAID is popular not because of lack of care but because Québécois values their autonomy and quality of life above being simply alive for the longest time possible.

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#77

“The algorithm cannot say no, however. If it finds problems, it sends the request for review to a team of in-house nurses and doctors who consult company medical guidelines. Only doctors can issue a final denial.” As a physician, I’ve had to speak to these so called “peers” in a peer to peer denials with both my clinic and hospital setting. They are usually people who aren’t physicians as a first line of their defens…

I’ve saved a message that was reposted by Bill Ackman on dealing with denials. Thankfully, never had occasion to use it yet: >> So, your doctor ordered a test or treatment and your insurance company denied it. That is a typical cost saving method. OK, here is what you do: 1. Call the insurance company and tell them you want to speak with the "HIPAA Compliance/Privacy Officer" (By federal law, they have to have one) 2…

OCR is https://www.hhs.gov/ocr/index.html

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#78
post #70
post #45

Earlier quoted context omitted.

Legally speaking the health plan employee isn't practicing medicine in that circumstance. The requesting provider is still free to treat the patient, they just won't be reimbursed by the health plan. The requesting provider can do it for free, or the patient can pay cash. I do understand that those aren't realistic options in most cases, I'm just explaining the legal distinction.

> Legally speaking the health plan employee isn't practicing medicine in that circumstance Feels like convenient lawcraft to wash the health plan employee’s hands of liability. I’m sure the prevailing popular opinion would be that this is practicing medicine.

If "convenient lawcraft" is the new slang for "words have meanings" then absolutely. Insurance company employees talking about insurance is practising insurance. Nobody wants them to practice medicine, the question is whether they are they going to hand over the money or not. Money is not a form of medicine, even if the person deciding where it gets sent is medically qualified.

Although on the words having meanings front, whatever is going on here is pretty clearly not insurance at this point; it'd be better just to honestly call it welfare rather than force people to redefine the word 'insurance'. It is hard to talk to people in the US about actual insurance now because they don't have a word for it any more. Politically redefining 'medicine' too would be a mistake, important conversations will become incoherent.

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#79
post #45
post #12

Earlier quoted context omitted.

I feel like this should really be something people should lose their license over. By deeming something not medically necessary they are (in my opinion) effectively practicing medicine. If they aren't qualified to practice that specialty, or aren't acting in the patients interest we should really be getting malpractice suits on them and stripping medical licenses.

Legally speaking the health plan employee isn't practicing medicine in that circumstance. The requesting provider is still free to treat the patient, they just won't be reimbursed by the health plan. The requesting provider can do it for free, or the patient can pay cash. I do understand that those aren't realistic options in most cases, I'm just explaining the legal distinction.

If it's not medicine, why do they say the word "medical"? Why does the insurance company pay a doctor to do it, if they could pay someone cheaper to say those words? I'm not a doctor or lawyer, but if I had to guess, the answers are that the law requires it be a doctor exercising their medical training, while the company tries to hide behind arguments like this to get around the law.

Re: "Not Medically Necessary": Helping America's Health Insurers Deny Coverage

#80

Earlier quoted context omitted.

Every other country seems to solve it

[flagged]

If I used my imagination as an epistemic authority, I'd often be wrong. Why not gain knowledge through experience? Visit Canada and report back.
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