Oh my, I am sorry that happened to you and your little one. I hope you somehow were able to get help with the bill.barnhart wrote: ↑Fri Dec 06, 2024 2:43 pmI am one of those denied. Our One year old got a chest cold that grew increasingly worse and after enough time had passed that he should have been recovering, his breathing grew labored. We took him to the pediatrician who chewed us out and sent him straight to the ER. She didn't want us going home first, so I had to return with stuff for my wife to spend the night there. It was full of small children with similar symptoms, all being monitored.Ken wrote: ↑Fri Dec 06, 2024 12:47 pm United Healthcare had $22 BILLION in profits last year. Not revenues, net profits. And they are just one company among many. All of which were earned by collecting more money from enrollees than they are willing to pay out in coverage. That is literally the business plan of health insurance companies. And it is achieved by obsessively and systematically cutting coverage and payments.
The latest news is that they are now using AI to screen and deny coverage for Medicare Advantage patients. With error rates of up to 90%. https://www.cbsnews.com/news/unitedheal ... e-denials/
They are basically doing violence to people through bureaucracy. That is the world they are creating. And as we know from Matthew, violence begets violence.
Afterward we got a sizable bill and notice that United Healthcare had denied coverage because the patient was not "turning blue" (actual quote) and therefore it was not a legitimate health expenditure.
I can understand the frustration of people who pay their monthly healthcare and then get denied when requests are made to cover bills. And in no way do I defend health insurance companies denying legitimate health coverage. However, I wonder if some of the denial stems from doctors putting in false claims just for the money.
We had a friend, who after giving birth, received a report that was billed to their insurance. The report said that when still in the hospital, their newborn infant was checked for breathing problems, which amounted to a fairly large number of charges. My friend became concerned because she knew nothing of their newborn having breathing problems and she had no memory of meeting the doctor who did the examination. So, my friend called the doctor and questioned her. The doctor claimed that the reason my friend was unaware of the newborn's examination, was because my friend was sleeping at the time, and she didn't want to awaken her. My friend didn't accept that explanation and demanded to know the day and time the doctor examined the baby, which the doctor gave. My friend said she knows the doctor is lying, because she was awake when the doctor claimed she was there, as my friend's mother and sister were visiting over that time. And the baby was in the room with them. Finally, the doctor gave up and admitted, why should my friend care, because the insurance will pay, even though the examination never happened. My friend was livid. Later that doctor was expelled from having hospital privileges at local hospitals for insurance fraud.
And we all wondered how many doctors get away with that type of fraud.