My BP is rising. Perhaps you can complain to your carrier that they are ruining your health...
they will ask you those same questions over and over, then proudly pat themselves on the back for having this wonderful online
patient info system, where it shows all your meds, but they will ask you your meds over and over and over.
Actually Jay the insurance companies do want to do the right thing. I worked for one for many years and never saw an attitude of
screw the customer. It was always all about being fairly discriminatory, not unfairly of course. Being consistent so no one could play favorites.
Every insurance company will always ask you if the injury was due to a car accident or a work accident, because almost always those coverages are primary, not your health insurance.
It's why they ask this in the ER, they ask it everywhere. It's all about who to bill...
Of course in Property Casualty you had underwriters like me who could make exceptions, and I did regularly. And then I became an independent agent for a good part of my career
and again, from a corporate standpoint, they want the policy strictly adhered to, so the actuaries aren't fooled, and they want the claims paid within x days of receiving all requested documents.
Because without papering their files, insurance companies grind to a halt. This is contract law and you have to have documentation. It's been this way, and it always will be this way with claims over a certain dollar threshold. Insurance companies are almost as bad as banks, they have rules for everything and rules for their rules.
Where it all breaks down is when the local claims processing people act like one level above orangutans and take every bit of their allotted 30 days, if that is their number. The clock is always running on a claim. If you can help it, you never like them to stay open too long. But some companies I'm convinced intentionally delay payment as long as they are legally allowed, within some internal framework. Lot of money at stake for a big company.
Most problems I've seen have come from medical coding errors plus pre-authorization screwups.
Easiest claim is life insurance. Except for exotic exceptions. Some of the hardest are disability and any other areas where frankly folks can fake it.
If you catch enough folks faking it, you know where to look.
Health insurance is just an extraordinary paper chase along with some venal hospitals trying to take advantage of personal pay patients.
Plus today there is so much opioid abuse that anyone getting it legitimately winds up jumping through hoops at a time they least need to do so.
Not sure of the answer there.
And as soon as that claims threshold is made public, a whole industry of crooks will rise up gaming that threshold. Lot of 998 dollar claims...
As an insurance company underwriter and independent agent for almost 30 years, I could not begin to describe all the lies I have been told.
Including my best friend's father trying to cheat me on my first day of business.
Insurance company has lots of money, let's just stick it to them.
Well the them is us because any smart person knows as claims go up, the rates go up.
I have to wonder how much money these health care insurers are actually making. They certainly always seem to cry poormouth when jacking up rates, particularly now when
politics is so entwined with the health care rulemaking.
I have spent the last three hours throwing out old bills and financial stuff. The amount of paperwork Medicare sends every month is awful. All those extra sheets of paper, I wonder when English won't be the first page...
Someone could make a living being a medical insurance concierge, handling all this paperwork and acting as a patient advocate.
