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  1. #101
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    Quote Originally Posted by adrenalated View Post
    As any good lawyer will tell you, the first thing to do in any lawsuit is post about it on the internet.
    Awesome!

    OP - Nuke and behead!!!!

  2. #102
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    Quote Originally Posted by Skidog View Post
    yep totally broken. And I believe the ins co's live off the fact that tons of people will just "pay it" so the company wins.

    Ive had multiple instances of stuff not being covered when it should clearly be, all instances were billing errors on the part of the Dr in most cases. Simply refiling the claim with the right "code" gets the bill paid.

    Wonder how much they make off "mistake" payments.
    Probably a good chunk. My dad ran single doctor (just him) private oncology practice for 40 years and had 3 full-time staff who did nothing but deal with insurance companies and billing. That type of practice would be almost impossible nowadays because of the overhead. They hated dealing with insurance companies as much as the patients did. Figuring out correct codes for billing, then codes change. Or certain things have multiple codes based on whether it was a pre-existing condition(not usually covered), a condition that was related to the chemo treatment(sometimes covered), etc. And they were usually trying to get as much covered for the patient as possible because it was in the doctors best interest as well. All the doctors I knew would rather have guaranteed money from the insurance company (even if it was less than the true cost to the doctors office) than rely on debt-collectors to track down money from people who usually didn't have it in the first place.

    All the doctors in my family will readily admit the current system is fucked in many ways
    "They don't think it be like it is, but it do."

  3. #103
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    Currently dealing with in-network vs out-network PT. My new PT has been told by insurance that they are in-network and out-network during the same week by different people at the insurance. I was told by my insurance that they are in-network. My first appt is next week. Iím anticipating a headache dealing with how this is handled by insurance.

  4. #104
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    ^^^^^ Great, but people want to keep their fucked up insurance. Sure, whatever you say Uncle Joe.
    Quote Originally Posted by leroy jenkins View Post
    I think you'd have an easier time understanding people if you remembered that 80% of them are fucking morons.
    That is why I like dogs, more than most people.

  5. #105
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    Quote Originally Posted by Joey Joe Joe Junior Shabadoo View Post
    Probably a good chunk. My dad ran single doctor (just him) private oncology practice for 40 years and had 3 full-time staff who did nothing but deal with insurance companies and billing. That type of practice would be almost impossible nowadays because of the overhead. They hated dealing with insurance companies as much as the patients did. Figuring out correct codes for billing, then codes change. Or certain things have multiple codes based on whether it was a pre-existing condition(not usually covered), a condition that was related to the chemo treatment(sometimes covered), etc. And they were usually trying to get as much covered for the patient as possible because it was in the doctors best interest as well. All the doctors I knew would rather have guaranteed money from the insurance company (even if it was less than the true cost to the doctors office) than rely on debt-collectors to track down money from people who usually didn't have it in the first place.

    All the doctors in my family will readily admit the current system is fucked in many ways
    And for the record I totally do not blame the Dr....this is the insurance company messing with folks.
    http://www.firsttracksonline.com

    I wish i could be like SkiFishBum

  6. #106
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    Quote Originally Posted by Skidog View Post
    yep totally broken. And I believe the ins co's live off the fact that tons of people will just "pay it" so the company wins.

    Ive had multiple instances of stuff not being covered when it should clearly be, all instances were billing errors on the part of the Dr in most cases. Simply refiling the claim with the right "code" gets the bill paid.

    Wonder how much they make off "mistake" payments.
    But . . . but . . . everybody is supposed to be totally happy with their insurance so we shouldn't have Medicare for all. At least that's what the pundits say.

  7. #107
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    Thread bump time!

    RE: United Healthcare
    Biggest health insurer plans to deny ER bills if it doubts you had an emergency
    https://arstechnica.com/science/2021...-an-emergency/

    W.... T.... F....???!!! Those scumbags at United have always been freaking awful, but this one takes the cake. They've set a new low. Sad that when health insurance company after company went under or got acquired post-ACA, and after the dust settled, we were basically left with BCBS (teh suckage) and United (even suckier yet). Biden administration seriously needs to bring the hammer down on United for this new proposal of theirs. This CAN'T be legal, can it? I mean, it could be since they've probably had teams of lawyers examine every microscopic detail of the law before allowing this, but it does seem to cut directly against some of the intent of the ACA, which I THOUGHT was meant to prevent some of this nonsense, was it not?

  8. #108
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    There is a solution..... M4A..... just sayin.

    But that would be socialism
    I have been in this State for 30 years and I am willing to admit that I am part of the problem.

  9. #109
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    Quote Originally Posted by Bunion 2020 View Post
    There is a solution..... M4A..... just sayin.

    But that would be socialism
    M4A won't help unless we get rid of FFS.

  10. #110
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    Quote Originally Posted by old goat View Post
    M4A won't help unless we get rid of FFS.
    M4A will regulate FFS to the point that it will establish what can be billed. 800 lb gorillas tend to drive the discussion.

  11. #111
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    Drastic oversimplification by an internet know nothing: M4A will drive the private practices out of business unless reimbursement rates are re-assesed and adjusted upwards. The ones that remain will go FFS. The large hospitals will get suckier and suckier as they consume everything. I am all for socialized medicine, but it needs the willpower to adequately fund it. So it can compete with FFS for providers, among other things. I can't see Merica ever outlawing FFS.

  12. #112
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    Yo, not to poopoo the M4A et al discussion, since that IS worth revisiting, but I'd like to leave that for the other healthcare thread. I wanna talk specifically about the douchery that is this United Healthcare proposal in question. Time for some C-Suite executives to get some swift kicks to the nuts. Maybe a little light water-boarding for good measure. Can we bring back the good old fashioned wooden pillory so we can toss rotten tomatoes and cabbages at them?

  13. #113
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    Quote Originally Posted by Peruvian View Post
    Maybe one of our Canadian counterparts with that commie health insurance could explain what to do.
    you walk in, they ask for your health # and date of birth ( very important ) yer in and yer always covered

    but we don't have the option to chose the HC we can't afford, its one size fits all just like the green hats with the red star on the front were one size eh

    edit: didtnt realize how old this thread is
    Lee Lau - xxx-er is the laziest Asian canuck I know

  14. #114
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    And the vast vast majority of doctors in the commie canadian health care system are paid fee for service - billed directly to the government.

  15. #115
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    So you guys are saying "NO" to doing this to the United Healthcare CEO and his ilk?



    Asshole makes close to $20MM every year FWIW.

  16. #116
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    Quote Originally Posted by MontuckyFried View Post
    So you guys are saying "NO" to doing this to the United Healthcare CEO and his ilk?



    Asshole makes close to $20MM every year FWIW.
    I'm opposed to throwing a cat...
    Quote Originally Posted by blurred
    skiing is hiking all day so that you can ski on shitty gear for 5 minutes.

  17. #117
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    Quote Originally Posted by MontuckyFried View Post
    So you guys are saying "NO" to doing this to the United Healthcare CEO and his ilk?



    Asshole makes close to $20MM every year FWIW.
    Why do you hate capitalism? Why do these executives owe you anything? They are beholden to maximize profits, and if you have to be bankrupt because you thought you were having a heart attack but werenít, so be it. They have budgets to meet and jets to buy. You should have done more Google research on your diagnosis before you went to the ER. Take some personal responsibility.

    If this is such a big deal people can switch health insurance companies. And if their current employer only offers healthcare through UHC they can just switch jobs. Quit blaming others for YOUR decisions and take some personal responsibility.

    You really expect millionaires and billionaires to pay more than 1-5% in taxes so you can have health care? What are you, a socialist?

  18. #118
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    According to ski bro MD the gov gives them each a billing number and they just bill directly. Mostly its all the same procedures/ codes so they know them off the top of their head, they know what is allowed cuz they are pretty smart. Ever once in a while bro would say he had to do a days office work instead of ski so I think he was just submitting a months work all at once.

    I was on the OR table twice in the last year for a scope and an ACL there were no bills and no insurance companies, but you might wait longer cuz of availabilty, I met a woman who kacked her ACL after me but got fixed before me cuz she was way more facked up/ couldnt move the knee at all and i'm ok with that

    OTOH Dental is NOT covered in the communist system up here so yesterday the dentist sez I need a crown, they will email off a quote to the insurance co to be approved ... very different
    Lee Lau - xxx-er is the laziest Asian canuck I know

  19. #119
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    no one will have their lives upended and their finances bankrupted due to a dental issue - if they did it would be something that turned medical and then it would be all covered under a communist system

  20. #120
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    well exactly ^^

    altho drugs arent covered which could be life threatening
    Lee Lau - xxx-er is the laziest Asian canuck I know

  21. #121
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    Quote Originally Posted by neufox47 View Post
    Why do you hate capitalism? Why do these executives owe you anything? They are beholden to maximize profits, and if you have to be bankrupt because you thought you were having a heart attack but werenít, so be it. They have budgets to meet and jets to buy. You should have done more Google research on your diagnosis before you went to the ER. Take some personal responsibility.

    If this is such a big deal people can switch health insurance companies. And if their current employer only offers healthcare through UHC they can just switch jobs. Quit blaming others for YOUR decisions and take some personal responsibility.

    You really expect millionaires and billionaires to pay more than 1-5% in taxes so you can have health care? What are you, a socialist?
    Haha, exactly.

    sent from Utah.
    sigless.

  22. #122
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    Quote Originally Posted by bennymac View Post
    no one will have their lives upended and their finances bankrupted due to a dental issue - if they did it would be something that turned medical and then it would be all covered under a communist system
    It's still very short-sighted. Poor dental health is causally related to a number of expensive systemic diseases. Dental care is extremely cost-effective preventative medicine.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88948/
    https://www.dentalhealth.org/news/hi...st-three-times

  23. #123
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    Quote Originally Posted by neufox47 View Post
    Why do you hate capitalism? Why do these executives owe you anything? They are beholden to maximize profits, and if you have to be bankrupt because you thought you were having a heart attack but werenít, so be it. They have budgets to meet and jets to buy. You should have done more Google research on your diagnosis before you went to the ER. Take some personal responsibility.

    If this is such a big deal people can switch health insurance companies. And if their current employer only offers healthcare through UHC they can just switch jobs. Quit blaming others for YOUR decisions and take some personal responsibility.

    You really expect millionaires and billionaires to pay more than 1-5% in taxes so you can have health care? What are you, a socialist?
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  24. #124
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    Quote Originally Posted by Dantheman View Post
    It's still very short-sighted. Poor dental health is causally related to a number of expensive systemic diseases. Dental care is extremely cost-effective preventative medicine.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88948/
    https://www.dentalhealth.org/news/hi...st-three-times
    agree 100%. But try getting dentists to agree to be funded by a government and have their fees regulated - while at the same time try convincing a government that spending money intelligently can often save you money later.

  25. #125
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    I am assuming that this move by UHC will be litigated to death by any number of entities...
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