Ex-United Healthcare Employee BLOWS WHISTLE: FORCED to Deny Claims
[su_spoiler title=Please make sure these dispatches reach as many readers as possible. Share with kin, friends and workmates and ask them to do likewise. open=yes style=fancy icon=arrow-circle-1]Jordan CharitonSTATUS COUP NEWS[gtranslate]<• Choose your l...
This is hard for me to understand. No one in my family has ever been denied coverage or procedures. Young, old, or infirmed. Perhaps it's timing, but years ago we had United Healthcare... had a major brain issue with a teen, all covered.
I just don't understand why some are and some aren't.
I would say the same for me, but the difference is that when I was working, I was with huge companies that were self insured and their coverage for employees was of the "Cadillac" variety. Everything my doctors threw at them before I retired, was covered, meds too.
I know others who unfortunately work for organizations that have cheap plans and they encounter rejections frequently. Usually for a utilization review, or if the recommendations are approved by in house DR's and Nurses. At that point, you're at their mercy, dragged thru the process, hoping you'll just go away.
I agree, I’ve never even heard of any health insurance company rejecting things that the policy states are covered. Of course an insurance company might suggest you do certain things before approving either expensive surgeries or drugs or whatever but that’s understandable
Notice how people say the companies just generally “reject coverage”. Well if your health plan doesn’t include the thing you need done then of course they’re gonna reject it. If I ask my health insurance to cover my eye exam it will be rejected because that’s not part of the plan.
Yeah, I had United when I needed an emergency c-section and had no problem getting it covered, and they also didn’t give me any problems with having a scheduled c-section the second time around. My out-of-pocket max was crazy high though, but my BCBS plan that I have now is the same way. If anything I blame hospitals more than insurance companies. The prices that were on my hospital bill were obscene. They billed my insurance $80k for each c-section/2 day hospital stay, and that was with no major complications or special care.
Reminder: An insurance policy is a CONTRACT. Read it, understand what you're covered for. If they deny coverage clearly listed in the policy, you can sue. Tons of greedy lawyers willing to go after these giants.
The big issue is people flat out don't understand what is and is not covered. And, what's worse, is these mega-insurance firms COUNT on that to abuse their victims. Knowledge is power. Ignorance gives that power up.
There’s also an issue of them potentially saying “hold on a ““minute”” let’s check if that’s right” “Oh hey good news, looks like you’re covered! Oh, you’re already dead? Well isn’t that just too bad”
...indeed...
I have United Healthcare and have been very happy with it. Same for my aunt.
Healthcare.... that's one of the thing s named the opposite of what it does. The DS gets a kick out of that stuff.
The murderers with the 'helping hand'
You mean like: Gender Affirming Care (mutilation) and Reproductive Care (abortion) and End of Life Care (death)?
Exactly...
Coming from someone who talks to seniors on the daily selling these advantage plans, I rarely hear claims being denied. I do hear that they take a while to pay claims but this usually doesn’t affect the client just the office that is doing the billing. That’s why there is always controversy with hospitals and groups dropping carriers, bc they’re not getting paid fast enough so they threaten to drop their network. Then almost always they come to an agreement. I hate our medical system as a whole but would think I would get a lot more angry clients if their claims were being denied like this article is claiming. The people that complain the most usually have no idea how the system works and missed a step in processing and that’s why their claims was denied.
...thank you for the report live from the belly of the beast...
...where we howl 1, we howl all...
where ever money and profit are involved, you will have people denying care because of financial reasons. same goes with the government...
..."money makes the world go 'round"...
And what's wrong with that? If the company pays out more than it takes in it will go out of business.
so at times, to limit the expenditures of a health care company, some people will be denied treatment that they otherwise, in good times for that company, would be authorized to get their treatment...
when obummer-care gave the insurance companies monopolies in their regions.. well you can't " switch " to a better provider, can you?