Why do we have to do the health insurance company's job for them?
Why do we have to do the health insurance company's job for them?
Just so tired of almost every time a doctor submits stuff to insurance, we have to be the ones to make multiple phone calls to both the doctor's office and insurance to iron everything out, figure out what the issue is (it's always a different issue), and basically be the go-between for the office and insurance. What am I paying $500+/month for?! It's like paying for the privilege of having an exhausting part-time job.
And yes, I understand that insurance wants to weasel out of paying anything, but this isn't even shadiness, just straight up incompetence and lack of communication/following procedures. The amount of emotional energy we have to spend untangling this stuff leaves us drained.
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One of the biggest advantages I see from living under single payer health care is that I don't have to put in extra clerical work like you describe. Sure, the insurance company should be able to pick up a phone, but In my opinion, the responsibility should rest on the hospital - they are the ones demanding a payout.
I worked in healthcare tech for a long time and I would say that healthcare facilities should focus on delivering healthcare. We had so much administrative overhead from dealing with this insurance bullshit that it drove up costs to staff a ton of people to deal with insurance bullshit and thus increased costs. If we had single payer it would be a single process that couldn’t possibly be more convoluted than what we have now. Sending shit to insurance clearing houses with exact ordering of diagnosis matching procedures so that they don’t get kicked back. The hospital doesn’t want you dealing with this shit either they just want the money that the insurance provider said it would pay for your treatment. It’s 90% insurance bullshit all the way down.
Just to offer another perspective, this covers just how difficult the burden of administrative tasks already is for physicians: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522557/
Not all physicians work for a hospital, so I don't think they all have much access to large departments that can take up the slack for them. It's difficult to ask them to chase our insurance for us when the paperwork they already do is driving them insane and taking them away from their patients.
The solution, as you said, is single payer. The overwhelming administrative overhead is a symptom of a very broken system. Nobody directly rendering or receiving care is benefiting from how things currently are in the United States.
I do feel sorry for the admin staff that have to deal with it, and my ire is 90% directed at insurance. However, when they can’t even read the back of the insurance card to follow the instructions to properly file a claim, it just gets tiring.
I completely agree about it being the providers responsibility. The problem is, they don't want to do anything to resolve the issue either. Other times, it doesn't even involve the provider, they did everything right but for some byzantine reason it didn't go through the insurance system correctly and you have to call them and tell them to process it the same way they have processed every other exact same bill from the exact same provider.
Just wanted to vent. I should clarify I live in the US (as if that wasn't clear from my post LOL!)
they don't want to do anything to resolve the issue either.
In any other line of work, that's an excellent way of forfeiting any right to getting paid.
In the jobs I've had where I've had to bill someone, I'm having a hard time imagining that I could expect to get paid if I just sent a bill to someone who didn't owe me.
The patient is ultimately liable to make the payment. You sign that when you get the service. So if the insurance company isn't forking out, the provider may send the bill to collections.
I disagree. The hospital is employed to provide medicine. I pay a medical insurance company to pay for my medicine. If a doctor says I need medicine the insurance company should respond and pay because why else am I paying them.