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Denying Your Medical Care is Big Business in America
(www.nytimes.com)
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this post was submitted on 23 Mar 2024
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The insurance companies use computer algorithms to deny claims and most people won't fight it.
Most people can't fight it. Fighting a claim, depending on insurance, requires multiple different Doctors recommending the same thing. Sometimes the insurance requires prior steps taken that are unavailable to individuals (I was required to take antibiotic that I'm allergic to before a surgery). Getting into a specialist can take months, and the costs of seeing a specialist are not often covered at all (goes towards deductible), and unless you live in or near a city you may not be able to find specialists you don't need to get a hotel to see (travel expenses and time off work are not covered). Not to mention, if fighting a denied claim rolls over to the next year, everything starts over, even if you have the same insurance it's considered a new policy because it's a new year.
Unless you have unlimited time and money, fighting a denied claim is pretty difficult and goes nowhere fast. That's how the system was designed.