If your medical insurance denies you for treatment, here's a possible solution
(media.greatawakening.win)
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This person is absolutely correct. Some years back my wife was denied surgery for varicose veins. We filed a complaint with the state department of insurance and they ordered BCBS to pay for a second opinion by an independent vascular surgeon who said she should have had the surgery a year ago and was essential for her to remain alive.
Turns out the doctor at BCBS who denied her original surgery request was a psychiatrist. What a fucking joke.
Psychiatrist? Whaaaaat? 😵
It’s dumber than that. BCBS (and others) basically just pay for the signature.
They have an analyst or AI try to justify not doing it then they present the patient packet to a pool of doctors and have them “bid” on signing it. Insurance just pays the lowest bidder.
Usually it works because most people just cave.
It’s basically just bonus money for these people because the company hides their license information.
If it gets out that people demand this information, it could do massive damage to the industry which you love to see.
Yes, the ramifications of this are clear!
Fascinating strategy. Thanks!!!
One of my doctors uses this strategy and is constantly complaining that his peer review is from a doctor in a different field. He is a vascular surgeon and one of my denials was done by a pediatrician. He always wins in the end, but it always delays things :-(
I might have to use this for Long Term Disability. They said they are reviewing my records to see if this was case of pre-existing conditions(which is only valid because I had just gotten the insurance 5 months prior and it's in the contract), it's not a pre-existing condition though!
I'm worried they will pit their doctor against the VA's doctors to say I can still work. Wouldn't that be funny.
Let us know how it works out.
My insurance provides coverage for gender affirming surgery but repeatedly denied coverage for my son to have mastectomy for gynocomastia. For god’s sake, he is just a boy wanting to be a boy who grew breast tissue because our environment and food is so horribly fucked up. He is a boy wanting to be a boy but that was not deemed medically necessary even though they will deem cutting off a young girls breasts or a young boys dick off medically necessary if they think they were born in the wrong body!
This is a great post. Can it be pinned for Frens to document results fighting the specific insurance companies denial of claims?
Excellent, thank you! It seems everyone’s strategy is to deny and make you fight for it. I think many insurance companies started to use this strategy to try to stop fraud, but now it is just a blanket denial for everyone. Instead of addressing the fraud, they punish the innocent.
Also they save more money for themselves if they have a doctor denying your claim
Insurance companies only make a profit if they don't pay. Think about it...
I think it’s automatic AI driven denials as the new standard.
I still think it's super weird that people can know how evil the medical industry is and yet they still go to them for every sniffle and hang nail they might get.
Why would anyone trust those people after they have shown their intentions to harm and even kill their "patients"?
Good post.
Seems like great information, thanks.
Brilliant.
Another point: How can a long-distance doctor make a diagnostic decision without ever seeing the patient in person? How could such a decision be superior to the doctor who did see the patient in person?
Impossible.
A courtroom jury would likely agree, if you want to go there.
This is why electronic records were demanded in the Obamacare package. To practice medicine, you basically need a nurse and a secretary plus a thousands of dollars per month database all so that when you submit a claim, the insurance industry has your complete medical record.
I tell people to expunge their records at least yearly from wherever they have gone.
How do you do that? Would love to.
Every health chain is different. Most have a "records" department. Call and ask for the procedure to purge your records.
T/u!
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Bookmark, ty fren
I'm glad my insurance pays almost everything for my immunotherapy treatments. The doctor bills almost $30,000, and I only have to pay $10. I think that's pretty good. And everything the oncologist has requested has been paid on by insurance. Somehow, CT, MRI, and PET scans cost me $100 each, so I haven't had a lot of them.
If my insurance ever turns, I'll have to use this information.
Place I work with just uses CCR to go down a check list for prior approval, no clinical background needed. Perhaps its reviewed by someone clinical but that's not what I was told.
Example they use to deny stuff is FDA standards. So a lot of experimental stuff is flat out denied because of it, in fact most denials is because drs are prescribing it in an experimental way from what I have worked with
Does this work for Medicare also?