My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company.
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@Brad_Rosenheim You are paying more per year for a “no-pay” insurance, than many in the EU pay in their taxes that gives them free heath care.
The difference is that insurance companies are not stripping out all the $$$ in the EU.@IncHulk Exactly. We are paying dearly for a product that is absolute shit.
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My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company. The woman who is speaking to her has informed her that there is a nursing support call that is free of charge if my wife needs to discuss the emotions of getting this claim denied and to plan future care. It is such bollocks. USians generally hate our healthcare plans and these companies. Imagine facing surgery and being told that they won't pay for it, but they will pay for a nurse to call you and console you about their decision. Absolutely horrific.
Oh, and I pay over $3,000 per year for this level of health insurance for my family.
#USHealthcare
#PrivateInsurance
#MedicalCare
#medicine
#surgery
#healthcare
#insurance@Brad_Rosenheim @darthsandwich I’m so sorry, Brad. It’s inhumane and unconscionable. Capitalism is cancer. Sending you both all my love.
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@Brad_Rosenheim @darthsandwich I’m so sorry, Brad. It’s inhumane and unconscionable. Capitalism is cancer. Sending you both all my love.
@aral
Thank you, Aral. -
@Brad_Rosenheim I'm sure you've received all sorts of advice, from a former billing & coding person, she needs to ask for
1) the name & credentials of the person who reviewed & denied the authorization & on what grounds
2) the denial in writing, specifying the justification for the denial, code by code
3) the page number in her benefits & coverage book indicating the planned procedure is not a covered benefitThen follow up the phone call with a certified letter signature required to dept head
Thank you for this advice. As another future victim of this insurance provider (I get to pay about $6k in family premium, yay) I appreciate it. Have not been denied for a surgery (haven't needed one yet) but have struggled though a couple of medication denials is good to know what to ask for.
Have also been offered the nurse line I think because my daughter had a couple of ER visits back to back - I thought it was some kind of scam at first fishing for info.
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no, this is literally not true
1st, "profit" is an accounting term that even under GAAP is a bit elastic, but lets say around 20% right now
so, ok, you could save what 5% on the health insurance bill if you elimminated insurance profit ?
pfft@failedLyndonLaRouchite @acm_redfox @Brad_Rosenheim
And this is not quite right.
Medicare processes claims at much lower cost than private insurance companies in no small part because what is and isn't covered and how much will be paid is established before claims are submitted.
This is what all-payor pricing does and why every other developed country does it in one form or another.
It's profit and the inefficient free for all of our lack of universal rules applying to everyone in the system. -
My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company. The woman who is speaking to her has informed her that there is a nursing support call that is free of charge if my wife needs to discuss the emotions of getting this claim denied and to plan future care. It is such bollocks. USians generally hate our healthcare plans and these companies. Imagine facing surgery and being told that they won't pay for it, but they will pay for a nurse to call you and console you about their decision. Absolutely horrific.
Oh, and I pay over $3,000 per year for this level of health insurance for my family.
#USHealthcare
#PrivateInsurance
#MedicalCare
#medicine
#surgery
#healthcare
#insurance@Brad_Rosenheim This is atrocious. I'm so sorry for what you and your wife are going through.
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My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company. The woman who is speaking to her has informed her that there is a nursing support call that is free of charge if my wife needs to discuss the emotions of getting this claim denied and to plan future care. It is such bollocks. USians generally hate our healthcare plans and these companies. Imagine facing surgery and being told that they won't pay for it, but they will pay for a nurse to call you and console you about their decision. Absolutely horrific.
Oh, and I pay over $3,000 per year for this level of health insurance for my family.
#USHealthcare
#PrivateInsurance
#MedicalCare
#medicine
#surgery
#healthcare
#insurance@Brad_Rosenheim
I am so sorry.
I am fighting for surgery for my husband too. -
@Brad_Rosenheim
I am so sorry.
I am fighting for surgery for my husband too.@NorcalGma2 Sorry to hear that. I had read your post about Summer reacting to your husband's voice when he called home, but did not realize that the hold up was insurance. We are hoping they cover it for him! For my wife, it seems like a long battle with insurance ahead. They had a conference with her doctor on Friday afternoon and they have decided to still deny it. The doctor has never seen this and has done hundreds of these surgeries.
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@NorcalGma2 Sorry to hear that. I had read your post about Summer reacting to your husband's voice when he called home, but did not realize that the hold up was insurance. We are hoping they cover it for him! For my wife, it seems like a long battle with insurance ahead. They had a conference with her doctor on Friday afternoon and they have decided to still deny it. The doctor has never seen this and has done hundreds of these surgeries.
@Brad_Rosenheim
It's not insurance but similar. He is covered by the VA which doesn't cover the surgeon he needs. They would send him to another doctor, who isn't familiar with him, at another hospital. Until we get everyone on the same page we can't get him transferred. We have to get his infection under control here at our local hospital too. I am doing everything I can to advocate for the best surgical options for him.
This is all beyond stressful and doesn't need to be so difficult.
I wish you all well in getting a better outcome from your insurance. -
@Brad_Rosenheim
It's not insurance but similar. He is covered by the VA which doesn't cover the surgeon he needs. They would send him to another doctor, who isn't familiar with him, at another hospital. Until we get everyone on the same page we can't get him transferred. We have to get his infection under control here at our local hospital too. I am doing everything I can to advocate for the best surgical options for him.
This is all beyond stressful and doesn't need to be so difficult.
I wish you all well in getting a better outcome from your insurance.@NorcalGma2 Our fingers are crossed for both of you that the stars align and everything works out. Best of outcomes to him, and to you (and Summer).
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My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company. The woman who is speaking to her has informed her that there is a nursing support call that is free of charge if my wife needs to discuss the emotions of getting this claim denied and to plan future care. It is such bollocks. USians generally hate our healthcare plans and these companies. Imagine facing surgery and being told that they won't pay for it, but they will pay for a nurse to call you and console you about their decision. Absolutely horrific.
Oh, and I pay over $3,000 per year for this level of health insurance for my family.
#USHealthcare
#PrivateInsurance
#MedicalCare
#medicine
#surgery
#healthcare
#insurance@Brad_Rosenheim is the consolation nurse also available for people related to murdered healthcare denial CEOs?
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My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company. The woman who is speaking to her has informed her that there is a nursing support call that is free of charge if my wife needs to discuss the emotions of getting this claim denied and to plan future care. It is such bollocks. USians generally hate our healthcare plans and these companies. Imagine facing surgery and being told that they won't pay for it, but they will pay for a nurse to call you and console you about their decision. Absolutely horrific.
Oh, and I pay over $3,000 per year for this level of health insurance for my family.
#USHealthcare
#PrivateInsurance
#MedicalCare
#medicine
#surgery
#healthcare
#insuranceI knew a sociopath that worked for UHC. That person would brag in detail about denying claims over the phone and how they dropped the voice a few octaves to fake being their own supervisor.
The only recourse that I know is to find a patient advocate with experience in the medical care field that will effectively do the legal work to get your coverage approved.
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@Brad_Rosenheim
It's not insurance but similar. He is covered by the VA which doesn't cover the surgeon he needs. They would send him to another doctor, who isn't familiar with him, at another hospital. Until we get everyone on the same page we can't get him transferred. We have to get his infection under control here at our local hospital too. I am doing everything I can to advocate for the best surgical options for him.
This is all beyond stressful and doesn't need to be so difficult.
I wish you all well in getting a better outcome from your insurance.Hang in there. We’re all pulling for you from afar.
️ -
I knew a sociopath that worked for UHC. That person would brag in detail about denying claims over the phone and how they dropped the voice a few octaves to fake being their own supervisor.
The only recourse that I know is to find a patient advocate with experience in the medical care field that will effectively do the legal work to get your coverage approved.
Patient Advocate Foundation (PAF): A national nonprofit providing free case management for patients with insurance denials, coverage disputes, or large medical debts, particularly those with chronic conditions.
Hospital-Based Advocates: Ask for a patient representative, social worker, or financial counselor at the hospital where you receive care; these services are often free but limited to that facility.
For comprehensive, undivided loyalty, search directories like the National Association of Healthcare Advocacy (NAHAC) or the Alliance of Professional Health Advocates. These professionals may charge hourly fees or contingency rates.
Check your Medicare Advantage plan or employer’s Employee Assistance Program (EAP) for included care coordination or case management services.
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@IncHulk Exactly. We are paying dearly for a product that is absolute shit.
Our premiums are 1500 a month, AND we have a $6,000 per person deductible, with a family max of 12k out of pocket.
It’s obscene.
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