( – promoted by buhdydharma )
There is a bit of a Cold War of sorts, raging between Private Insurance “providers” and your neighborhood Health Care professionals (and it’s NOT the Govt getting in between the two.)
It’s the battle over Claim Denials. It’s an “arms race” that just keeps escalating …
DMI: Denial Management, Inc — The Claims Solution People
The Problem:
One in seven claims are denied by insurance companies. This can cost your clinic or practice thousands of dollars every year.
http://www.claimsmgt.com/produ…
That’s about 15% of Claims, Insurers choose NOT to pay. So, Doctors need all the help they can get, to stay focused on Healing, NOT Bill Collecting!
Denial Management Services
Problem: Most Health Systems lose between 3% and 5% of net revenues as a result of payment denials.
Solution: Outsource your denied claims to DMI, the foremost industry leader in capturing additional revenue.
http://www.claimsmgt.com/compa…
DMI answers questions from Doctors on their FAQ page:
Q: If we were to purchase your product, how long would it be before we can expect to realize a return on investment (ROI)?
A: Larger facilities (300+ Beds), on average, realize ROI in as little as 90 days. Smaller facilities, physician offices and clinics are more likely to realize ROI in 180-240 days.
http://www.claimsmgt.com/compa…
Incredible, Doctors now have to resort to hiring 3rd party services and super-sleuth software, just to get Insurance Companies to hold up, their end of the “social contracts” they’ve sold us!
That Status Quo has just got to GO!
Enough of the Bean Counters already, rationing our well being — WHAT do they know about the Practice of Medicine anyways?
Sure they have Profit/Loss ratios, for every Disease imaginable — BUT what gives them the right, to “Play God”, with our Health?
What gives Private Insurers the right — to hold our Economy Hostage, with annual premium increases, about 3x the rate of Inflation?
Perhaps they have other Hidden Costs that they just can’t keep under control?
Ron Williams – Aetna
Total Compensation: $24,300,112H. Edward Hanway – CIGNA
Total Compensation: $12,236,740Angela Braly – WellPoint
Total Compensation: $9,844,212Dale Wolf – Coventry Health Care
Total Compensation: $9,047,469Michael Neidorff – Centene
Total Compensation: $8,774,483James Carlson – AMERIGROUP
Total Compensation: $5,292,546Michael McCallister – Humana
Total Compensation: $4,764,309Jay Gellert – Health Net
Total Compensation: $4,425,355Richard Barasch – Universal American
Total Compensation: $3,503,702Stephen Hemsley – UnitedHealth Group
Total Compensation: $3,241,042
(many thanks to nyceve, for compiling this Health insurance industry CEO salary survey)
Perhaps Insurers are just caught in that Competitive Spiral with other Private Insurers, to gain the most (profitable) marketshare, at the least out-of-pocket costs (for them)? Perhaps the Insurers’ Shareholders, are just more important than your individual Health Care?
God forbid you actually get sick — cause then you’ll have a “pre-existing condition” — we all know that makes you “One of the Untouchables” in the profit-models of Private Insurance. Sure, your neighborhood Health Care professionals, will still want to treat you, but Look Out when those Medical Bills, ALL end up in YOUR In Box, unpaid. …
And if you Lose your Job — Forget about it! … that’s paramount to a Death Sentence in many cases! Unemployment and Health Care, apparently just don’t mix.
Think I jest about this Care Denial problem, well the Health Insurance Industry is concerned enough, to track some Consumer Stats. I guess they can’t afford to alienate Everyone, can they now? … Only their chosen few …
Top 5 Reasons Insurance Consumers File Complaints Against Insurers
March 6, 2009
A total of 195,669 confirmed consumer complaints on insurance companies were reported in 2008 calendar year.Top Five Reasons for Complaints in 2008
Total No. Percentage Delays 26,844 19.1% Denial of Claim 25,851 18.4% Unsatisfactory Settlement/Offer 20,021 14.2% Premium and Rating 6,644 4.7% Cancellation 5,618 4.0% Source: National Association of Insurance Commissioners
www.naic.org
http://www.insurancejournal.co…
(those are stats from the Insurance Industry’s own Association — the real numbers, the “unconfirmed” complaints, are probably much worse.)
What is Insurance FOR anyways? (if not paying for our Health Care?)
Don’t you already have enough bills, to be able to afford an ever-increasing “monthly tithe” to those distant and unpredictable Insurance gods, who may or may NOT, choose to pay your Doctor Bills, when you get sick!
If Only, there were some semblance of Economic Justice in this Country, many of those Insurance Claim-Denial-robots, would already be stripped of their Bonuses, stripped of their Benefits, and stamped with a Red Scarlet tattoo, across their Foreheads with this single word
DENIED!! 
See how those CEO Execs, like being Labeled as Lepers for a change! See how they like being the Outcasts of Society.
See how they like it when their only recourse, is to wander into an emergency room, that will only treat patients bloody, or on the verge of Death! … and then, STILL send you the Bill!
Bet those CEO’s and their Denial-cohorts, wouldn’t like it much …
If Only … We had the representation to match the People’s Outrage and the People’s Will.
Perhaps then, there would be NO Wall, between Doctor and Patient?
Perhaps Wellness would not be something doled out, as a privilege, to those lucky “profitable” enough, to still be among the fortunate {still affordable} ones.
So I say again,
Tear Down this Wall, Mr. Private Insurer!
QUIT Playing God, with People’s Lives!
Otherwise, there will be Hell to pay, someday —
If there is any Justice at all, left in this world …
The Ailments that put you on the Insurer’s Drop List
More Charts for Polls on National Health Care
Enough! … The People DEMAND at minimum a Real Public Option! NO Excuses, and NO Substitutes!
And the People SHALL be Heard!
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if you aren’t mad,
you aren’t paying attention!
Each of the Health Insurance groups mentioned above have CFOs and 4 or 5 Executive VPs (or the equivalent title) who garner multimillion dollar annual compensation packages as well.