https://www.propublica.org/article/e...authorizations
Insurers do not make explicit demands for more denials, a former EviCore sales executive said, Instead, they asked about “controlling the spend” — the amount of money paid out on certain procedures, he said. Nor would EviCore always use the word “denials” — they employed circumlocutions like “inappropriate determinations.”
Sounds like something right out of the fucktard biz speak thread
Sent from my iPhone using TGR Forums
swing your fucking sword.
Republicans are always talking about “2nd Amendment solutions” to our nation’s problems, this healthcare CEO just found out what that really means.
Thoughts and Prayers.
Sent from my iPad using TGR Forums
"Zee damn fat skis are ruining zee piste !" -Oscar Schevlin
"Hike up your skirt and grow a dick you fucking crybaby" -what Bunion said to Harry at the top of The Headwaters
You're not wrong.
United Healthcare to their own CEO: "We're sorry, but your bullet wounds are a pre-existing medical condition. Have a nice day."[click]
Sent from my Pixel 8 using TGR Forums mobile app
The clock ran out on the anesthesia and he died because he went into shock from the pain.
Vigilante justice is just a form the black market. It is the free market supplying justice demands that misregulation prevents the open market from meeting. (tic)
Originally Posted by blurred
Health Insurance profits are the closest thing we have to legalized blood money, and no one gives a shit if a hitman or mercenary gets killed. We’re just finally getting around to pulling the mask off.Originally Posted by tang;[emoji[emoji6[emoji640
You gonna come up with that 500k for,your by pass by yourself.
Fact is, not even medicare for all addresses the joke that is provider costs. That’s why your insurance is so high, not the less than 10% the ins co investors keep.
CEO's are just going to ramp up their personal security, they aren't going to have much of a wake up call. They've justified their choices to themselves years ago.
It’s not about high costs. At a certain point, the profits are blood money.Originally Posted by Cono Este;[emoji[emoji6[emoji640
[ATTACH][emoji6[emoji640][emoji637]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji638]]][emoji6[emoji640][emoji638]][emoji6[emoji640][emoji637]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji6[emoji640][emoji637]][/ATTACH]
Oh, and he was facing insider trading charges from the DOJ, because it appears he’s an unscrupulous piece of shit across all aspects of his life and career.
That's a load of shit and you know it. You are ignorning the insane amount of admin/paper shuffler/claims handling bullshit jobs/software/consultants/leaders/losses on the healthcare delivery side that go into dealing with all the fuck-fuck games that insurance companies play with pre-auth/claim denials/delays/etc/etc/etc especially from a company like United that auto-denies nearly half of all claims.
You also ignore follow on effects. If United pays so little for mental healthcare that there are basically no providers willing to sign up with them, and there is a long waitlist, and a sick person has repeat PC visits waiting and PC is trying med manage someone outside of their expertise who also needs psychotherapy, well UHC doesn't care because UHC doesn't pay much because it is in deductable/denial and they are only motivated to minimize costs. When that patient finally gets in with a MH provider, then United denies the service, care is more delayed, then pt attemps suicide and ends up in my ER after an Ambulance ride United didn't pay on and and we sit on their hold for 2 days before we can move them to a MH inpatient which are shorthanded due to low reimbursement and high refusals. Then when the patient is in the MH hospital, United case management demands they be discharged ASAP before they are stable because they only care about immediate threat to life "is the patient going to kill themselves as soon as you discharge? Then why are treating them? They can see outpatient next month!"
Then you repeat that cycle until the patient completes suicide, guess what?
Practically:
Massive unnecessary visits and costs generated in the system for the worst outcomes while the insurance company ends up on top
Fiscally:
Providers are underpaid and or not-paid due to denials
The hospital is not reimbursed because United refused to pay
United minimized their costs and maximize their profits
What payments are finally received don't cover the cost of care and the cost of extracting the payment from United
Bottomline:
Patient suffered needlessly and died wrongfully because insurance is allowed to work that way
That is just one example of why nobody is crying for this CEO.
Originally Posted by blurred
Please don't quote Cono.
Insurance company motivations:
How often can I refuse to pay?
If I must pay, how little can I pay?
How long can delay paying?
NOT insurance company motivations:
Customer's health in any way that doesn't affect their short term bottom line
Costs and burdens imposed on the healthcare system
Costs and burdens imposed on patients
Hospitals and providers are evaluated and paid based on patient outcomes.
Why not insurance companies? Of cours they'd just obfuscate and cook the data...
Originally Posted by blurred
(Note that the statement in the first post here is incorrect)
https://x.com/mattbruenig/status/186...sR_NcRK2VkCfkg
The excess costs in US healthcare are really everywhere TBH. Private insurance greed and inefficiencies, hospital chain monopsony, doctors being paid more than other countries (partly due to lobbying efforts),
This goes back decades, but a friends father was a doc. The dad can't deal with the amount of bs dealing with insurance companies, so the son decides to start a small business helping doctors navigate the insurance bs. Little company became successful, but adds another cost layer into our healthcare because of these insurance companies making it difficult on the doctors.
Also...this thread![]()
Don't leave out Big Pharma.
Have you seen what they are raking in for the new biologics for the autoimmune diseases? Truly obscene. The "cure" for an autoimmune condition can cost $90K for the initial treatment and then $40K per year in maintenance doses.
Not too many people would shed tears for a Big Pharma executive. Drug costs are a huge multiplier when comparing US vs other countries.
Oh hell yeah. The MS drug I was on cost 20k for 3 months supply. On Cuban's Cost Plus drug company...2k!
Bookmarks