We've known this all along

[Larra]

For many years, we've seen people who clearly need bariatric surgery for medical reasons stuggle with insurance denials. And, we've known that lots of people struggle with denials for all sorts of other medical care as well, though we haven't been as involved with this personally. Here is a little article verifying just how complex and frustrating this process is. And all just because insurance companies aren't really about providing medical care, it's all about making as much money as possible.

The Folly of Trying to Map Out the Appeals Process for Insurance Denials | MedPage Today

 

[hilary1617]

I also see a lot of insurance denials / struggles for other parents of children with disabilities and cancer groups.

 

[Larra]

hilary1617 very true! The article speaks to this, with one oncologist pointing out that you are cheaper dead than on chemo. It's a big issue with bariatric surgery, but in lots of other areas as well.

 

[JackieOnLine]

can't remember where I heard this but someone said the three things that should NOT be for-profit stand for life, liberty and the pursuit of happiness: healthcare, jails and education.

I agree with this.

 

[k9ophile]

And it's such a game. I worked for a peer review organization that routinely denied Medicare claims. It usually was for something like inadequate documentation, blah, blah. The bad part that affected my job was that we had to notify the beneficiaries so that the hospital couldn't go after them to pay the bill. So many people were confused. And of course, we had to submit these boiler plate letters to Medicare for approval. The letters were once denied because they were too vague and too specific. Then when insurance companies saw the bullshit Medicare was doing, they followed suit.

As much as I hate dealing with insurance, I've only had to appeal/challenge a few denials.

Don't get me started on my job at a for-profit health-care facility.