One of the non-obvious effects of Obamacare is that health insurance companies are starting to narrow the size of their healthcare networks. In theory a narrow network of high-quality hospitals is a good thing, but in practice we are likely to see a significant variation in the quality of specific networks. In fact, this is one of the few ways in which insurance companies are allowed to compete under the new rules, so variation seems inevitable.
This situation is important to technology people because universal and affordable healthcare is expected to enable more entrepreneurship; the risk of striking out on your own is now much less because you can still afford medical care. But narrow networks can be a big surprise for people who aren't expecting them. If your kids have to get a new and untested pediatrician, then that increases the risk again.
These new narrow networks affected my family directly, it was a shock that we only learned at the doctor's office when they couldn't process our insurance. It turned out that the doctor was a member of a different, but similiarly named, PPO from the same insurer.
(Score: 2) by kaszz on Thursday May 15 2014, @01:38AM
Seems like nice system to encourage stagnation.
(Score: 4, Informative) by edIII on Thursday May 15 2014, @01:39AM
They may make you sign some fancy agreements where the debt ultimately resides with you, but when I negotiate beforehand and they say my insurance is an acceptable form of payment, they can go suck a fat one if they think they can change it afterwards.
I don't see that any different than saying they would accept Discover, and come back and say no. In this case, my money is not a suitable alternative because I couldn't have afforded it without insurance in the first place.
Currently fighting over 20k worth of medical debt that was in fact already paid by the insurance. They came in and took it back direct from the hospitals and private practices. While I feel for the practices that are coming after me, it's not my problem. I always verified that insurance was going to pick it up first.
After starting this Great Depression along with the rest of the country, I already ditched the reporting agencies, cut up all my cards, and told them to go suck it. I'm not going to be faced with crushing, crippling, and unfortunately invisible debt in the form of national debt that paid them already. Double dipping bastards started the whole thing. Since I refuse to play their game, and it's healthier for me to live within my means completely, I have denied them forever any form of control over me due to credit. I'm surviving, and they can't threaten me.
The point of that rant was, the worst they can do is take you to court if you stop playing the credit game. For something as offensive as denying a previously agreed upon payment method, I doubt they will find much traction in a jury trial which is what I would demand.
It should be federal law that once a hospital or medical practice tells you that the insurance agreed, liability switches to the insurance company and the consumer is strongly protected.
That's not a new idea either. Some laws have been passed in various states I believe that forces insurance to pay out the minimum required liabilities in a car accident, as long as insurance was current. That's regardless of whatever mistakes were made creating the policy. What prompted this was the DOI in various states finding that insurance companies were refusing payouts and cancelling a ton of policies because they were not well written or vetted. One of the few places where the Man is forced to accept his consequences.
Technically, lunchtime is at any moment. It's just a wave function.
(Score: 5, Interesting) by kaszz on Thursday May 15 2014, @01:50AM
The American system works in the way that whoever can outspend the other in terms of lobbyists and lawyers wins. Usually people are poor and corporations are rich. You loose.
(until the system is patched)
I like your method of ditching credit. It's a liability in any way you put it. Loan interests turns just about any person into an economic system peon.
(Score: 3, Insightful) by frojack on Thursday May 15 2014, @02:03AM
Probably too late to try to put someone else's fingers in the vice.
When you find out you really can't keep your doctor just because the highest official in the land said you could, and there is not a god dammed thing you can do about it, good luck trying to enforce any promises downstream.
There will be boilerplate. There is always boilerplate.
No, you are mistaken. I've always had this sig.
(Score: 3, Interesting) by Angry Jesus on Thursday May 15 2014, @03:26AM
> I don't see that any different than saying they would accept Discover, and come back and say no.
They verified the insurance information before anyone saw a doctor, so it wasn't a billing problem, it was an inconvenience problem.
(Score: 2) by edIII on Thursday May 15 2014, @03:53AM
Read it one more time:
Process implies just that, a process. It all falls under billing, so I don't see how it's convenience here. This relates to a data processing error where the person at the front desk made an assumption based on a similar name. That's their error, not the patients.
It's not just an inconvenience. You may as well have been running a business asking for 9 gajillion federal credits. I don't have federal credits. Almost nobody in this economy has federal credits. People that have federal credits aren't at the street level like me, but have their own private jets and custom legislation service through a popular prostitution ring in D.C. that also takes federal credits.
The only thing I have is a little amount of money that I give an insurance company each month. They handle the whole federal credit deal.
Considering these facts, everybody must go through the process of verifying insurance for each and every specific line item that you want done. I don't even get to choose what I want, and if it's appropriate. I can't do that, I have no federal credits. The insurance decides if I live or die (not hyperbole, friend is dying and they won't do anything), and if I really needed that procedure or not.
Consumers should not be liable for this at all. Ever. If a processing problem comes back over operator error like this that individual is now placed under a heavy financial burden. They were further retroactively deprived of the ability to assess or mitigate the risk, even if they made every reasonable attempt to do so prior!
There are NO alternatives when insurance comes back after the fact and denies it. People don't have the money, and healthcare in a country with 30% efficiency and ranked 43rd in the world, is not sustainable or affordable. It's a game where insurance is literally required unless you are quite substantially better off than average. It's 100% billing on this.
P.S - This crap happens all the time. I'm overdrawn in the bank by a couple hundred now because the girl screwed up on a deposit. Even got confused and asked me and I told her the account by name and handed her an ATM card linked to it. I'm sure as fuck not paying the overdraft fees that just got assessed either.
Technically, lunchtime is at any moment. It's just a wave function.
(Score: 1) by Angry Jesus on Thursday May 15 2014, @04:02AM
> Read it one more time:
LOL. I fucking WROTE it.
> P.S - This crap happens all the time. I'm overdrawn in the bank
If this crap happens all the time to you, then you might want to consider the one thing that all of these events have in common.
(Score: 1) by edIII on Thursday May 15 2014, @04:19AM
If you wrote it, then you should write it *better*. "Processing insurance" is a term I only ever hear after services have been rendered, not before. Following that up by stating a confusing between similar names for PPO only compounds the problems. You could have said, "Before services were rendered".
As for the last comment... fuck you too buddy. I specifically told her something that she ignored. I'm not mad at her directly, but it's an example of a common billing error. What's also very common is that business likes to shift the consequences of their errors onto the customer instead of owning it.
Go get a drink, get laid, get fucked, or whatever. If the only response you have is to unfairly denigrate me, I can see who's debate skills are lacking.
Technically, lunchtime is at any moment. It's just a wave function.
(Score: 1) by Angry Jesus on Thursday May 15 2014, @04:29AM
> If you wrote it, then you should write it *better*. "Processing insurance" is a term I only ever hear after services have been rendered
LOL, sorry for not using language the one true way.
> If the only response you have is to unfairly denigrate me, I can see who's debate skills are lacking.
I don't really see a debate going on here. Just you getting livid because your solipsism started to crack a little bit.
(Score: 2, Insightful) by goody on Thursday May 15 2014, @06:57AM
As long as insurance companies have the ability to game the system to make more money, they will do it, regardless if it is to the disadvantage of the patient. Capitalism doesn't work for healthcare. We need to go to single payer and relegate the insurance companies to "on top" insurance, like they do in other countries.
(Score: 3, Interesting) by kaszz on Thursday May 15 2014, @10:19AM
You may only succeed with that if you can quell lobbyists and punch a hole in the media exclusion zone.
(Score: 2) by bob_super on Thursday May 15 2014, @06:26PM
I typed a detailed reply, but I actually managed to blow up my cynicism monitor, while staying within the boundaries of Poe's law.
Can I just call you an Evil Commie and leave it at that? I don't have mod points...