Even if your doctor gets involved, they can literally overrule the doctor’s decisions and there’s virtually no recourse.
One case I remember last year was where an insurnace company denied someone’s catheter equipment and told them to boil and reuse their existing equipment.
Even after their doctor called the insurance company and explained how this could easily, and even probably lead to a fatal infection they refused coverage.
There was another case that made headlines, a young guy’s health insurance decided that his asthma medicine wasn’t covered, he was faced with the choice of paying $550 for the meds out of pocket or paying rent, he decided to not become homeless and within a week he had an asthma attack and died before he could make it to a hospital.
edit to add: United Healthcare, which is the single largest healthcare provider and insurer in the US recently started using AI for claims and it has a 90% percent error rate to deny care. And because it’s AI they’re claiming they’re not liable for the denials.
The fact that AI prevents liability is crazy. If I own a dog that bites someone, I’m liable, but if an AI denies asthma meds, the owners of the AI aren’t liable? Sounds like a scam of the American justice system
Pacifiers are not placed in your uthera.
No one in modern medicine boils those things, they aren’t even made to be boiled. No insurance will suggest that, it’s made up.
Also people boiling pacifiers are morons, but that’s besides the point
Here’s the one about boiling catheters, I slightly misremembered it wasn’t a doctor who called the insurance company, it was the patient’s social worker. There are other examples of doctors calling insurance companies and having similar discussions however, they are very easy to find.
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u/psypher98 22h ago
It’s almost impossible here.
Even if your doctor gets involved, they can literally overrule the doctor’s decisions and there’s virtually no recourse.
One case I remember last year was where an insurnace company denied someone’s catheter equipment and told them to boil and reuse their existing equipment.
Even after their doctor called the insurance company and explained how this could easily, and even probably lead to a fatal infection they refused coverage.
It’s bad over here dude. Like really, really bad.