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https://mas.to/@MikeBeas/113666556469008087
EDIT: I think you should get the service you pay for, just so that's clear.
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this post was submitted on 18 Dec 2024
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The worst part is, they actually hire doctors to analyze claims and they're the ones making the decisions whether the claims are accepted or not.
Edit: clarification
I'm sure the doctors stick with reviewing claims for which they have a lot of experience, spend the time to actually review the patient's specific scenario better than the doctor who saw the patient, and aren't financially incentivized to deny as many claims as possible.
Yeah that's what I was getting at. For some reason I'm being downvoted for saying how things actually work?
The person you’re responding to was being sarcastic. They’re bottom of the barrel doctors practicing outside their specialty and have a financial incentive to deny claims.
Yes I know! That's what I'm trying to say.
Text saying how it actualy works without any indication that you think it is bad sounds like approval of the existing system by default.
If you said 'the crazy part is...' or 'they hired the doctors to give themselves the appearance of medical doctors making qualified decisions' then maybe it wouldn't have come off that way. Instead, it comes across as 'yeah, but they have doctors making the decisions so it is fine'.
Ah ok I see. It's a misunderstanding.
Well, we were responding to the words that were there and not the unsaid context. Even with your edit you are missing something making it clear why the worst part is that they are hiring doctors to deny the claim.
I included the parts you seem to be in agreement with and included the 'better than the doctor who saw the patient' both to make it clear it was sarcasm and why having doctors deny claims is not in the best interest of the patients.
😓
It's all good!
Took me a long time to figure out how much detail should be included and sometimes I still screw up and ride the down vote train into oblivion. The other thing I learned is that clarifying rarely helps, most people see that as making excuses because people in general are terrible judges of other people's intent.
Shouldnt a doctor be "reviewing" the patient before making decisions?
Like wtf is is this middle manning. You go see doctor, then another insurance doctor is checking his homework but only based on paper work and with a financial incentive to deny as many claims as possible.
Also, I bet they explicitly state they are not rendering care when they review a claim, CYA legal shit. So are they even acting in their capacity as medical professional or just paper pusher with an MD. I don't think it even requires a licese.
Exactly.