leshawk
43416
1979
59
Dec 21, 2024 8:48 PM
leshawk
43416
1979
59
idrinkcheapbeer
we are at the point in american health care where the best advice is "JUST USE AN UNO REVERSE CARD"
Logoth
@OP I think it is, and a couple of reposts ago someone quoted a source that thoroughly debunked this entire process.
rossimus
Or you could just shoot an insurance rep
Photeus
Honestly, unless you're seeing repeated denials for the same date of service, typically all you need to do is call and they will reconsider and pay the claim. You might have to wait 2 hours on hold, but they are hoping you won't bother.
Notmybeardedladynotmycarnival
Or,
wannasee
And now you can have AI fight the denial for you-
https://www.fighthealthinsurance.com/
countervail247365
And you know, you can feed these all into AI to help make this easier.
TinyOctopus
Or. y'know.
varyael
SterlingArcherSecretAgent
It's extremely dystopian that you need such tactics to "hack" the healthcare system.
DaCrazyBeggar
"Top 5 ways to try to escape the orphan crusher"
mentalmasticator
tgrwillki
For Anybody that needs a template to request these things:
https://docs.google.com/document/d/1S6o2V-zaCAxhoKHxxjBNJh-Tu4CyztRIVMAwyBMVZqs/edit?usp=sharing
Make a copy of that doc, and share it along.
fester9
It's a repost and also completely bullshit. Try this and the best response you'll get is the middle finger from your insurance provider.
HelpfulCorn
The correct approach is to follow your insurer's documented appeals process.
Goatfer
Key part buried in the middle. "IF the insurance company answers them honestly"
twoamartist
Another thing to check out is if you require a procedure or have to to the ER, ask for the cash option instead of using insurance. Most times you will find it’s way cheaper, and they will work with you on a payment plan.
Ryebread91
Reminds me of the time where the dr denying the claims was a surgeon forbidden from further practice because he put a hip in backwards. (Which is as impossible as it sounds)
iCritiqueYourComment
honestly ima just fuckin die before i do this stuff
cowgoesmoo1
That's how they win.
ChaoticGoofy
VitaminJay
Claim Denied? I know a guy...
Richter12x2
At least for the moment. My treatment was finally approved on appeal, then 6 months later they retroactively denied it and started keeping every reimbursement until they repaid themselves the $4,000. Even getting them investigated by the Federal government didn't help, but after 2 years of fighting and appealing, they finally paid $1,200.
zylokun
Insurance companies don't have to give you any of this and will probably just hang up on you
Ididntcomehereforthis
There is an easier way... #DDD
SithElephant
SlyPhinleyTheFirst
ExecutiveProducerWolfDyck
That's a lot of work, I say we just keep gunning down execs.
https://youtu.be/RQthFDpYCys?si=zRs-wNogs5zyqb9f
TofuGolem
I have a better solution: we keep attacking CEOs until we get universal healthcare.
sambaah05
I know we won't get universal healthcare any time soon, but if the government wants to actually do something, mandating that this information must be provided upon requests seems like a low bar that could help a lot. As long as the insurance company is doing everything properly, they have nothing to worry about!
emu314159127001
Well, managed to get as far as "...if the government wants to do something," before my logic circuits registered a category error. I was going to ask if you're from one of the actually civilized countries, but then i see you started out with "we." Hence the logic loop.
Whatdoyousaytoanicecupoftea
"I was only obeying orders"
SpamYarBlockers
Requiring this would hurt profits though. Not gonna happen. The only way to change the system is to find it some alternative revenue stream
neptix
They would never give up the money, even if you found them another source, they'd just gobble both. the only way to fix the system is to burn it down and try again.
sambaah05
Affordable Care Act limited insurance company profits. It can be done.
TiredBanana
If the government wants to actually do something? As in something that benefits the citizens and not just the oligarchs?
Oh, honey...
sambaah05
Meh. We got the affordable care act that helped citizens. While it wasn't perfect, things are *slightly* better. Just need 60 Dem senators again, probably 62. The issue is we are getting the government we deserve. There are a lot of Americans who don't want the government to help. While that sucks, that's a reality.
TiredBanana
The affordable care act that still left people with insurance paying thousands out of pocket for a sprained ankle? Obama might've had noble intentions, but in the end it was a bandaid on head trauma.
sambaah05
People forget that before ACA, insurance companies could deny offering you coverage for pre-existing conditions. Now they can't. That used to be a huge problem. The Medicaid expansion helped more than 10 million people get on Medicaid. Women now can't be charged more than men - a reminder - they used to be. I think those are good things that helped a lot of people. I'll take stuff like that all day, every day. If was a bit more than a bandaid.
TiredBanana
Well a bandaid and a painkiller maybe. But it's a 100 dollar painkiller with a 10 cents a piece manufacturing cost.
InDogsWeThrust
Fuck that. Luigi method.
Ptrik
I give you 10 upvotes with more on the way
Thekindofkindlyman
ExecutiveProducerWolfDyck
https://youtu.be/RQthFDpYCys?si=zRs-wNogs5zyqb9f
PlaceHolderTitle
IHaveAGuyForEverything
People keep saying that, but no one is doing it.…
Dekker3D
My excuse is that tickets to America are expensive...
LiterallyAWizard
https://nypost.com/2024/12/19/business/michigan-company-boss-stabbed-by-employee-in-possible-copycat-crime/
WickedSludge
One guy did. Maybe people are waking up...
Sen7ryGun
Americans, talking a massive game and doing fuck all while they get cucked into oblivion by corporations. Name a more iconic combo.
WickedSludge
This American upvoted you from -1
Ididntcomehereforthis
It is, but the media isn't reporting it now, lol. Can't have that showing as effective, now can we?
YouwontlikewhatIhavetosay
Cause they want to see change happen, but don't want to be the one who makes that change happen. Funny innit?
TheWombatStrikesAgain
That's the nature of revolutions. Every single one begins with a bunch of people getting absolutely murdered. The first few of the people storming the Bastille got shot. The first few people protesting Assad got imprisoned and tortured to death. What makes a successful revolution is that people just say "Fuck it, even death is better than this life!" and keep coming.
If it was easy, revolutions would happen all the time.
ExecutiveProducerWolfDyck
We've been conditioned to be passive towards injustice all our lives. We gotta keep working at breaking free of that.
420supercoolusername69
IMPORTANT: if you request certain treatments/therapies and your doctor refuses, TELL THEM TO CHART THE REFUSAL. I had a family member go through a bunch of bs with insurance companies and this was recommended by the attorney she worked with. It came in handy down the line.
Roqinn
When I inured my back 16 years ago, I told the doc that my back was hurting and a spot to the right of my spine, near my hip. He told me on multiple occasions that it's just my back and referred pain. He never documented my complaints. To this day, my greatest pain is currently the spot I was complaining about and since he didn't document it, insurance says that it isn't related.
hobbitdoc
Isn't related to what? What was he documenting if not that? Did you have a laundry list of things? If so then you probably needed multiple visits to cover all of them.
filurilurl
Referred / reflective / radial pain is a bitch simply because the true source often requires the kind of mapping that involves multiple people eliminating source problems rather than a "simple" medical solution. I'm incredibly grateful that the pain I actually felt mostly in my right hip in my teens was eventually found (thanks to multiple specialists looking at it and cross referencing their results) to be an issue with my spine that fairly simple exercises alleviated.
hobbitdoc
This is stupid. I've said it before and I'll say it again. Your doc has no control over insurance approvals. It doesn't cost us anything to provide something. If we don't provide it, it is because it isn't warranted or indicated. Being a pain in the ass about it isn't advocating for yourself, it's advocating against decades of training.
Go to a fake doctor if you want to make up your own treatments. They'll provide anything for the right price.
WhiteKnighted
Yeah this is bullshit. My doctor has deliberately not suggested treatments because she thought my insurance wouldn't cover them. 1/2
WhiteKnighted
2/2 How do I know this? I asked her, she explained. I asked "and if money was no object?" and she then offered me additional treatments.
AranaDiscoteca
I like to think of this as being more of a bad doctor thing. Like... 99% of all doctors I know would happily write down "Patient saw a commercial for a medication that has horrible reactions with their other medications And I refused" or something for why they'd refuse treatment on their chart so future doctors knew what they were dealing with. If someone is hiding that, that is sketchy.
420supercoolusername69
You replied to me before about this, calling patients “obnoxious” and saying it was a “good way to get your physician to hate you.” After getting downvoted to oblivion, to deleted the comment. Seems like you’re still an asshole, and if you do practice medicine, I feel absolutely awful for anyone in your “care.”
hobbitdoc
There are definitely bad physicians out there and I get that people have bad experiences. But most of us didn't go through hell just to get some sick satisfaction from saying "no" to patient requests. The majority of us just want to help people get better. And this pervasive attitude on imgur that you should have a adversarial relationship with you doc is fucking stupid. 1/2
hobbitdoc
I'm trying to explain to people that physicians are human too and I can promise you that if you make their job more difficult they will absolutely not give you the extra TLC that other people are getting. They will probably constantly refer you elsewhere just so they don't have to deal with you (hint if you're getting lots of referrals it's probably cuz you're obnoxious). No one here wants to hear that perspective. If you want good medical care then establish a good relationship. That's it.
mwoodman
Isn’t warranted or isn’t indicated? Great, then chart that. Problem solved. But don’t pretend doctors are both infallible and uninfluenced by external pressures. Literally the term “get a second opinion” exists because of your profession.
hobbitdoc
You are correct. A good physician shouldn't have a problem documenting their refusal. However, in a litigious society even a warranted refusal can be a liability and putting your provider who has dedicated their lives to helping people on the heals does not make for a good relationship.
mwoodman
As the husband of a wife with chronic illnesses who has been repeatedly dismissed by conventional doctors as untreatable because there isn’t a pharma solution… and then treated by NP docs who either won’t take insurance or who charge exorbitant “concierge” fees… both of whom have millions in malpractice insurance while we have nothing to fall back on… it’s a tall order to ask me to trust any doc has her best interests in mind and please don’t insist on charting refusal of care.
AranaDiscoteca
That sucks and I'm very sorry that you ran into those individuals who have done these things.
IceWeaselX
If the insurance company insists on X treatment which my doctor refused, you bet your ass insisting on having it charted is advocating for myself. I now have it in my medical records that my doctor said not to do it.
Having a paper trail isn't always about getting one over the doc.
hobbitdoc
That's not what this is referring to. They are saying that you should pressure your doctor to provide treatments they don't think is warranted by essentially threatening them.
Any good physician would automatically document why you need a treatment that isn't the preferred treatment from an insurance company. That should never have to be asked for. It's part of the process.
Richter12x2
If you think asking them to chart their refusal is threatening them, then you need a better doctor. I've talked to my doctor about treatments all the time, here's a good example: my doctor prescribed Contrave to help with weight loss, but it's not covered by insurance and its $400 so I couldn't do it. Researched it, Contrave is a combo drug of bupropion and naltrexone, which are both covered drugs. So I asked if it made sense to do it that way, and now the $400 med is $60 a month.
420supercoolusername69
Nope. I’m talking about doctors exactly like you who don’t listen and try to absolve themselves of responsibility and accountability when they’re wrong. Us using the system to keep you in check shouldn’t feel like pressure, but considering it’s your inconvenience or my life, you can fuck off and write whatever the fuck I tell you.
hobbitdoc
You can go to a fake doctor to get "whatever the fuck you tell them". For my patients I'm going to provide whatever is evidence based and literature supported. I'm not a monkey here to do tricks for you. I'm here share what I know after 15 years of 90+ hour weeks and one of the most gruelling training regimens in the world.
AranaDiscoteca
May I posit that both of you are talking past each other and perhaps are equally guilty of presuming the other is awful and responding back with that in mind?
DanielAsparagus
Idk who downvoted this. But it’s a tactic that fucking terrifies doctors. They have to chart it. In front of you. Suddenly their tune changes. Fast.
RemanentSky
I'm so sorry this has been your experience. I don't understand why this would be the case from the doc's perspective. Anytime I ever don't recommend a treatment I'm asked for I chart why it was asked for and why I don't think it's appropriate whether I' masked to or not; if being asked this question changes the doc's tune, I really have to wonder why they're saying no in the first place.
Richter12x2
Yep. If you ask them to write it down and they get scared, you need a new doctor.
DanielAsparagus
In my experience (I’m in mental health) it has a lot more to docs not taking people seriously when they’re borderline personality disorder. Add that to bipolar and docs will be 100% hands off unless you push them.
rusrsdude
Could be a number of reasons or even none at all, but it really doesn't matter. What matters is that it's charted for your own sake. Doctors are people, too, and people suck.
RemanentSky
Oh 100%, I didn't mean to suggest you SHOULDN'T ask this, at all. I'm just sorry to hear it's been anyone's experience that a doc has reacted nervously to being asked to chart their decisions, and I openly wonder why a doc wouldn't just do the thing they were nervous about not doing.
Idsertian
Explain for my public healthcare having ass: What is charting a refusal?
stoney2005
Charting is part of your health records. So it basically means documenting their refusal to do what the patient requested
Idsertian
Thanking kindly.
AranaDiscoteca
It's not always bad. Sometimes it's things like "Would not give the patient ivermectin. Because they're in here for a rash. And, also not a horse." Which was a real thing my dad had to chart while I was working in his office.
Idsertian
Wow. I should not be surprised at the depths of humanity's continued stupidity, and yet, here I am.
Hayashima
I bet some doctors' notes would make for amazing reading, similar to some court records' greatest hits
DanielAsparagus
Oh I read medical records all day. My fav was “patient wants antibiotic for hiv. Was injected by ex’s new gf who sneaks in at night. Client has not seen her do this, but says new gf is a ninja.”
hoopsnek
In Australia we just get treated by our doctors. At least you have freedom there though I guess.
funnyfaceking
This guy hasn't heard the song.
junkgoof
Freedom to give money to billionaires and to die without health care. No freedom to do what you want without harming others.
losersmanual
The freedom of illusion.
Hotjoe1991
FREEDOM TO DIE FROM EASILY TREATABLE CONDITIONS AND FREEDOM TO GET BURIED IN CRIPPLING MEDICAL DEBT MURICA 🇺🇸🇺🇸🇺🇸🦅🦅🦅🦅🌭🌭🌭🥧🥧🥧🥧🥧
Hurch
We're an example of unrestrained capitalism. It's the way of the Ferengi, and it's not a good way when everything is based on profits.
bikingbinks
Need a bike mechanic down undeer? I <3 your use of swears. I can bring my own tools.
CyberHexx
I would give up the GOP's version of "freedom" in half a mother fucking heartbeat if it meant I could live in a sane and compassionate system.
Derpehh
This^
People will always point to super long wait times which is not true at all. You pretty much have the option of private or public health coverage. If you opt for the former you don't pay the surcharge at tax time.
If you opt for just public you pretty much may not be able to pick your doctor and you might have to wait an hour if you didn't book unless it is an actual emergency then you cut the line.
Most people still opt for private and the government limits the profits so no price gouge
DarkBusterBaron
Sure unless you're not a straight rich white man. Oh wait.
ILoveEveryone69
Australians lost a war to Emus. You literally got beat by birds
stewgru
But where are your guns? Disregard the fact you no longer have mass shootings.
LincolnFox
More like free dumb
Emjayen
and by "freedom" they mean access to guns, quite literally that's the line I've heard endless time from Americunts.
Adester
The freedom from choice!
rcgom
is what you got!
PathologicalLier
I love the irony of this
tachyx
They have all that freedom but aren't using the N word.
CyberHexx
Nationalize? As in Nationalize the Pharmaceutical and Insurance Industries?
funnyfaceking
Australia is very racist, so it's not the regular N-word they're not using.
OldmanSerious
"Very racist" is a bit harsh. At least here, being outwardly full on racist hasn't got anyone into power.
Yet.
myotherusernameismyotherusername
Only because y'all sent Murdoch over
Whatdoyousaytoanicecupoftea
...and in most cases, if you're using POS for payment, the government pays you back a whack of it straight away.
Bvella1404
Had an appt for my son the other week, it came to $660. Paid it up front, then the kind lady said to me "I'll just process your refund. Ooh is a good one" and I got $590 back. Went and bought a very nice lunch after.
astrangehop
POS?
onlyhalfghost
piece of shit
Dougamer
Point of Sale
Dougamer
Card
Hammertulski
Patient Offering or Sacrifice.
Whatdoyousaytoanicecupoftea
Point of Sale...so close. If you're paying by card at a terminal they usually refund the Medicare rebate on the spot
Hammertulski
If you leave an organ or two, they skip the settlement process altogether.
OnlyPositiveFavourites
Or better: in most cases the worst bill you have is carpark and a *heavily* discounted hospital pharmacy charge at discharge.
Whatdoyousaytoanicecupoftea
That said, the car parking around certain hospitals is ruinous
DMWildemount
Until not too many years ago (ok, maybe a decade or two), there were still plenty of 100% bulk billing GPs. For our non-Australian friends: that means even GPs wouldn’t need any payment, just a Medicare card. There are still plenty of places that do bulk billing for kids and health care card holders (low income earners).
cptunderpants
Australia is better but not perfect. My wife had a brain tumour removed and the gap/deductible and other costs totalled about AU$70k ($US$44k). I'm certain she'd be dead if we didn't have the money. As it is, she was left with some issues with cognitive function as a result.
DMWildemount
I’m sorry, that is awful and hopefully everything is going well for you. Can I check though, was that fully through the public system, or did you go partly private? I thought that all public was/is free, so just wanting to check.
cptunderpants
Public system (two different neurosurgeons) misdiagnosed it. Wife has a medical science degree, so she wanted another option and finally got someone who was willing to do more tests. Other surgeons said it wasn't a concern and to get annual MRI to ensure it wasn't changing.
Other surgeon was private but we also had highest level private health insurance.
I'd like to be able to write more but her case is unique enough she could be doxed easily.