Comments on: The Joys of Retirement http://www.bloggernews.net/119891 High-quality English language analysis and editorial writing on the news. Wed, 15 Feb 2012 09:18:05 +0000 http://wordpress.org/?v=2.3.3 By: Nancy Reyes http://www.bloggernews.net/119891#comment-1011192 Nancy Reyes Sun, 01 Mar 2009 00:17:20 +0000 http://www.bloggernews.net/119891#comment-1011192 Back in the 1990's, the New England journal of Medicine actually had an article listing all the ways that clerks could figure out how not to pay the bills sent in by doctors. Even with 1 1/2 secretaries to do the paper work, we never got paid for about 10 percent of our billings, and we were going broke. I figured that the payment to deliver every single baby paid by Medicare didn't even cover the increase in Malpractice insurance needed to cover OB, yet the nearest OB was 30 plus miles away, and wouldn't take Medicaid or illegal Mexican farm workers except as emergency patients (which is mandated by law). Which is one reason I left a small town that really needed me to go to work for the feds (IHS). It's gotten worse since then... I can't wait til socialized medicine...it will pay for needed stuff, but not "non essential" surgery (like fixing knees for joggers). Back in the 1990’s, the New England journal of Medicine actually had an article listing all the ways that clerks could figure out how not to pay the bills sent in by doctors.

Even with 1 1/2 secretaries to do the paper work, we never got paid for about 10 percent of our billings, and we were going broke. I figured that the payment to deliver every single baby paid by Medicare didn’t even cover the increase in Malpractice insurance needed to cover OB, yet the nearest OB was 30 plus miles away, and wouldn’t take Medicaid or illegal Mexican farm workers except as emergency patients (which is mandated by law).

Which is one reason I left a small town that really needed me to go to work for the feds (IHS).

It’s gotten worse since then…

I can’t wait til socialized medicine…it will pay for needed stuff, but not “non essential” surgery (like fixing knees for joggers).

]]> By: Sheller http://www.bloggernews.net/119891#comment-1010265 Sheller Sat, 28 Feb 2009 17:07:20 +0000 http://www.bloggernews.net/119891#comment-1010265 *************It is pretty obvious that many are terrified that they will lose their jobs and one begins to wonder if they are rewarded for cheating the customers. ***************************************** You discovered the secret held fast by many insurance companies in the past. Though clearly illegal, their first order of business on a claim, was TO DENY IT. They figured 60 percent of the people wouldn't bother fighting it...they were right. Of the remaining 40 percent, 20 percent would give up after the first try. Twenty percent would stay dilligent, with about 12 percent actually following through long enough to make them pay. ONLY paying 12 percent of legitimate claims makes for HIGH PROFITS for paper pushing. When profits still weren't high enough....invent HMO's (Health Maintenance Organizations with the untrained medical eye deciding on what is acceptable treatment per the HMO's bottom line)... Yes you hit the nail right on the head! *************It is pretty obvious that many are terrified that they will lose their jobs and one begins to wonder if they are rewarded for cheating the customers.
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You discovered the secret held fast by many insurance companies in the past. Though clearly illegal, their first order of business on a claim, was TO DENY IT.

They figured 60 percent of the people wouldn’t bother fighting it…they were right. Of the remaining 40 percent, 20 percent would give up after the first try.

Twenty percent would stay dilligent, with about 12 percent actually following through long enough to make them pay. ONLY paying 12 percent of legitimate claims makes for HIGH PROFITS for paper pushing.

When profits still weren’t high enough….invent HMO’s (Health Maintenance Organizations with the untrained medical eye deciding on what is acceptable treatment per the HMO’s bottom line)… Yes you hit the nail right on the head!

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