Health Insurance Companies - Their Abuse And Tricks, Part One

There is no doubt that there is little or no health insurance industry has a stranglehold on doctors and other health care providers and health care. There can be little hope that many of these insurance companies have become richer, their buildings become larger and stronger political lobbyists. CEO can control six or seven times the salary figure. In a significant number of cases, premiums grow and prosper, to save life or drugs and health are denied in the conservation. This series of articles will focus on attacks on health care providers and the health care system through a large number of health insurance companies. "The nation HMO net income of $ 3.6 million in the first three months of 2005, representing a $ 646 million or 21.4 percent higher than the $ 3.0 billion earned in increase during the first quarter of the year 2004, "said Weiss Ratings, Inc.

Abuse # 1: available.

Patient is to be seen in the office of a doctor, and he or she presents her Medicare card. Employee checks insurance and / or a valid reference (permission) of the insurance company to see the patient. The patient is seen to take on the health issue. The insurance will be billed. Doctor refuses request for payment. Pre-existing condition is the reason given by the insurance company. In other words, this state began (pre-existence) of insurance coverage. However, a doctor can not know, unless he or she first sees the patient and take a history. Doctor or other health professional can never be paid. The patient, despite the payment of premiums may be stuck with the bill. The insurance company collects the money. The fight is. Guess who usually wins, the company in this building 20 or 40 office floors plush company that has enough red tape to bind the service in the coming months. Guess who's in the rule.

Example: I was asked to consult on a patient to the hospital because she had blood and pain caused by kidney stones. Imagine my surprise, my application was refused as payment for pre-existing condition. The insurance claims that the stone was already in!

Abuse # 2: Transfer or permit

I believe that to require the practice of insurance companies that health care providers should not be allowed a special obtain (prior authorization or references). These references or prior authorizations may be imposed on a health-care professional before he or she can visit a patient a drug health maintenance, diagnosis, hospitalization or even an office. Referrals or prior authorizations in the care of late too many cases and can endanger the health of patients. They are barriers to care, and in many cases used as weapons in order to deny it to line the pockets of the insurance company. Is it not absurd to think that health care providers who have spent many years in the training and in fact can not the experts to decide for themselves whether a patient needs to be seen or has a drug or test purposes.

For example, a patient came to my office immediately after closing. I had seen in consultation in the past, uncontrolled blood pressure. She was not feeling well and she complained that her blood pressure was high. The insurance company was closed and we did not get a number. Of course I have given the patient and medicine to lower blood pressure seen. She felt better. I also prevents useless visit to the emergency room. The next day, as we. Insurance to explain our situation and they said they deny our right we saw without permission

Providers and patients should ask to speak and that our elected officials that industrial health insurance reform a priority.