1 minute ago, Arthur Jackson said:

YO CANT TRIPLE STAMP A DOUBLE STAMP

I can and I did. Suck it Benedict Cumberbatch. 🦅

1 hour ago, we_gotta_believe said:

Yeah I would think health insurance fraud would be one of the more difficult ones to pull off as you need a licensed doctor to conspire with, thus potentially risking their license to practice. Not saying that there aren't plenty of shady ass doctors out there doing exactly that right now, but it's probably far more rare than almost any other type of insurance fraud.

It's pretty massive.  I used to work large case medical fraud ring investigations in the Philly area and it's pretty insane.  Conservative estimates for total annual medical insurance fraud at the time, approx. 15 years ago, outpaced the total revenue of big box retailers like Target and Best Buy.  

Class warfare?  Ugh, thanks a lot Biden!

1 hour ago, DEagle7 said:

They're all crap, but United was absolutely one of if not the worst in the US when it came to denials. Fing scumbags. 

This decision is absolutely insane though. Rushing a surgical procedure where you run into complications will 100% cause an increase in deaths. It's an insane thing to try to pull even by **** insurance company standards. 

Totally agree, it is a stupidly ignorant decision. I think it is more about Anthem pushing back on the surgeons and anesthesiologists. Not that they have to rush every patient through surgery... Anthem will pay the standard rate of anesthesia for all procedures, but they will not be responsible if it goes over. Did they account for complications? They could become even more complex after this decision and Anthem will be on the books for the results of that. I feel like Anthem isn't thinking like medical professionals. They are thinking like cheapskates holding the pocketbook. It will come back to bite them.

21 minutes ago, Shepard Wong said:

It's pretty massive.  I used to work large case medical fraud ring investigations in the Philly area and it's pretty insane.  Conservative estimates for total annual medical insurance fraud at the time, approx. 15 years ago, outpaced the total revenue of big box retailers like Target and Best Buy.  

Not surprising who here is understanding of this murder. The same people who demanded the denial of medical care and services for unvaccinated Americans.

2 hours ago, mikemack8 said:

Sad thing is, for every time an insurance scumbag denied a claim, there were probably 10 instances where some scumbag committed insurance fraud.  

There is so much cheating and bad blood in this for-profit insurance thing. Doesn't it make you want to scrap it and go single-payer instead?

Just now, toolg said:

Totally agree, it is a stupidly ignorant decision. I think it is more about Anthem pushing back on the surgeons and anesthesiologists. Not that they have to rush every patient through surgery... Anthem will pay the standard rate of anesthesia for all procedures, but they will not be responsible if it goes over. Did they account for complications? They could become even more complex after this decision and Anthem will be on the books for the results of that. I feel like Anthem isn't thinking like medical professionals. They are thinking like cheapskates holding the pocketbook. It will come back to bite them.

This is one of MANY reasons OBGYN care has become such crap and the US maternal/fetal outcomes are comparatively such trash. Obstetric courses are paid a flat rate regardless of complexity of their medical course. Gestational diabetes is one of the most common complications of pregnancy. They will have dozens of sugar levels reviewed by a doctor each week and their meds adjusted in addition to twice weekly ultrasound and fetal stress tests in the office.  Insurance pays the exact same for that as someone who shows up for first time at the day of delivery and squeezes the baby out. 

3 minutes ago, DEagle7 said:

This is one of MANY reasons OBGYN care has become such crap and the US maternal/fetal outcomes are comparatively such trash. Obstetric courses are paid a flat rate regardless of complexity of their medical course. Gestational diabetes is one of the most common complications of pregnancy. They will have dozens of sugar levels reviewed by a doctor each week and their meds adjusted in addition to twice weekly ultrasound and fetal stress tests in the office.  Insurance pays the exact same for that as someone who shows up for first time at the day of delivery and squeezes the baby out. 

So why TF is this happening in the first place?

15 minutes ago, The_Omega said:

Not surprising who here is understanding of this murder. The same people who demanded the denial of medical care and services for unvaccinated Americans.

 

3 minutes ago, DEagle7 said:

This is one of MANY reasons OBGYN care has become such crap and the US maternal/fetal outcomes are comparatively such trash. Obstetric courses are paid a flat rate regardless of complexity of their medical course. Gestational diabetes is one of the most common complications of pregnancy. They will have dozens of sugar levels reviewed by a doctor each week and their meds adjusted in addition to twice weekly ultrasound and fetal stress tests in the office.  Insurance pays the exact same for that as someone who shows up for first time at the day of delivery and squeezes the baby out. 

Ironically, ob-gyn was one of the few opt-outs of Anthem's new policy, it was reported.

But yeah that doesn't seem right. Seems like there should be extra billable procedures in there when they're checking sugar levels and treating gestational diabetes. 

19 minutes ago, The_Omega said:

Not surprising who here is understanding of this murder.

Here, I'll pretend to shed a tear

Oh damn, couldn't even muster it.

 

Insurance companies suck, everyone knows that, but that heinous announcement about what they’re no longer going to cover is directly related to all of the ridiculous things that the government mandate they cover. We’re never going to get insurance reform without first getting government reform.

1 minute ago, The_Omega said:

Insurance companies suck, everyone knows that, but that heinous announcement about what they’re no longer going to cover is directly related to all of the ridiculous things that the government mandate they cover. We’re never going to get insurance reform without first getting government reform.

I'm sure the 30% denial rate from UHC is mostly because of the government and not absolute disgusting greed. Let's go with that.

7 minutes ago, Bill said:

So why TF is this happening in the first place?

A lot of reasons. Greed, ignorance, commonness of the care needed etc. But IMO the root cause is we don't value women's healthcare as a country. I know that sounds like a whiney liberal take but facts are facts. Comparable male surgeries can be compensated at nearly twice the rate of gynecologic procedures (eg laparoscopic hysterectomy vs prostatectomy). OB courses are bundled as I said before. When calculating the profitability of gynecology departments, hospitals often do not include the profits generated from labs, imaging, internal referrals or even as sick as this is the highly profitable infant NICU stays.  So they will often just slash departments under the guise of poor profitability without doing anything to address the root causes. The lobbying is weak because frankly the average Joe doesn't care. The results?

And by all indications this gap is widening. 

1 minute ago, DEagle7 said:

A lot of reasons. Greed, ignorance, commonness of the care needed etc. But IMO the root cause is we don't value women's healthcare as a country. I know that sounds like a whiney liberal take but facts are facts. Comparable male surgeries can be compensated at nearly twice the rate of gynecologic procedures (eg laparoscopic hysterectomy vs prostatectomy). OB courses are bundled as I said before. When calculating the profitability of gynecology departments, hospitals often do not include the profits generated from labs, imaging, internal referrals or even as sick as this is the highly profitable infant NICU stays.  So they will often just slash departments under the guise of poor profitability without doing anything to address the root causes. The lobbying is weak because frankly the average Joe doesn't care. The results?

And by all indications this gap is widening. 

The amount of OB/GYNs not "in-network" of a lot of base health plans is wild. Like you said, facts are facts.

 

This is how morally bankrupt the far left is at this point. A man is dead FFS.

 

6 minutes ago, DEagle7 said:

A lot of reasons. Greed, ignorance, commonness of the care needed etc. But IMO the root cause is we don't value women's healthcare as a country. I know that sounds like a whiney liberal take but facts are facts. Comparable male surgeries can be compensated at nearly twice the rate of gynecologic procedures (eg laparoscopic hysterectomy vs prostatectomy). OB courses are bundled as I said before. When calculating the profitability of gynecology departments, hospitals often do not include the profits generated from labs, imaging, internal referrals or even as sick as this is the highly profitable infant NICU stays.  So they will often just slash departments under the guise of poor profitability without doing anything to address the root causes. The lobbying is weak because frankly the average Joe doesn't care. The results?

And by all indications this gap is widening. 

So how is it fixed?

2 minutes ago, vikas83 said:

This is how morally bankrupt the far left is at this point. A man is dead FFS.

 

I do not advocate killing anybody.

Do I sympathize? Nah.

7 minutes ago, DEagle7 said:

I know that sounds like a whiney liberal take...

5 minutes ago, vikas83 said:

This is how morally bankrupt the far left is at this point. A man is dead FFS.

 

I saw one a-hole out there calling him a hero  

Just now, paco said:

I saw one a-hole out there calling him a hero  

YOU MEAN IN HEAR THEIRS A FEW

Just now, Arthur Jackson said:

YOU MEAN IN HEAR THEIRS A FEW

I did a search for hero but no hits. Maybe you were thinking of another thread?