The health insurance companies of America are lining up at the doors of Congress to commit legalized bribery like never before. In this time in which Congress and the President are trying to craft some type of health care legislation, insurers want to make certain that their feet are firmly under the table.
America’s Health Insurance Plans, the national association representing nearly 1,300 member companies providing health insurance coverage, reports that it spent $2.4 million just from July through September.
The non-partisan group Center for Responsive Politics reports that some drug companies are also outdoing previous efforts at buying influence. Pfizer has spent $16.3 million lobbying so far in 2009, and Amgen spent $9.2 million so far this year. Those amounts far outpace their 2008 bribes.
So, let’s run a total:
$ 2,400,000
$16,300,000
$ 9,200,000
$27,900,000
That doesn’t count individual companies like US Healthcare, Aetna, Kaiser Permanente, Humana, United Healthcare or any others. That also doesn’t count October and November.
But remember...there are 435 members of Congress and 100 Senators, one president and one vice president who is also president of the Senate. That totals 537 people. Divide the bribery total above by 537 and you see that each elected official could potentially have received $51,955.00 in contributions just from these lobbyists.
Remember also that the bribery is not done. Remember also that the opponents to this health care bill are also lobbying and bribing.
Even the AARP has spent a mind-boggling $15.1 million in lobbying bribes this year, which is less than they spent in the first three quarters of 2008.
Don’t worry about the insurance companies, though. Their profits are secure, and Congress will NEVER leave them out.
Why?
The insurance companies have vast investment portfolios. A big part of their portfolios are government bonds and other government securities. If the insurance companies sold off even 1 or 2 % of their holdings at once, they could cause the bond markets to collapse overnight. Washington knows this and won’t allow it to happen. So, insurers will get pretty much anything they desire.
As the old saying goes...“when money talks, all the bullshi* walks.” Don’t believe ANY headlines that tell you the insurance companies are dithering and worried. They have NO WORRIES.
Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Saturday, October 24, 2009
Thursday, April 16, 2009
Health Insurance: Top Five Strategies to Lower Your Medical Bills By Thousands
It’s a typical health insurance scenario. You or a family member has some medical procedure done. It usually involves a hospital stay. Within a few days or weeks, all of the bills come to you from the doctors, the hospital, the anesthesiologist, the labs, the radiology department, the surgeon...everyone who had a part of your health care event.
If you have health insurance through your employer, you’re usually only concerned about the amount of the bills not covered by the insurance. That would be your deductible amount and any co-pays you might have.
But what if some medical procedures are denied? What if some are underpaid? How do you challenge the determinations of the insurance company examiners?
Those bills can be in the thousands of dollars. For more serious illness and treatment, the bills can be in the hundreds of thousands of dollars.
Unfortunately, many of the bills are incorrect...sometimes wildly incorrect. Billing miscommunication happens daily on all levels. Doctor to patient, doctor to coding staff or billing service, billing service to insurance company, and insurance company to patient. Many miscommunications are due to poor interpretation of the facts. The right hand doesn't know what the left hand is doing.
The patient is caught in the middle, doesn't know who to believe, and being the ultimate bearer of the financial obligation, many times just pays the bill out of frustration. There is no average case, all situations are different, and no two problems are the same.
But, what can be done? How can a regular person...an average American faced with giant medical bills...determine the correct medical charges and get correct medical bills?
Strategy #1: Remain calm.
When calling the insurance company to dispute a payment amount or challenge a denial, insist on obtaining the full name of the person you’re speaking to. If they refuse, ask for a supervisor. I also strongly recommend recording every call. When you call into the insurance company, you’ll regularly hear that “this call may be monitored or recorded for quality purposes.” Don’t you believe it. They are covering their butt in case the claim goes into litigation. Get a recording of your own. Make sure you know the law on recording conversations in your state. You can find that information at: www.insurance-claim-secrets.com/support-files/phonerecordinglaw.pdf
Strategy #2: Become aware of “hot spots” in the health insurance billing process that are the source of many errors.
A major source of errors is the “superbill” filled out by your doctor. It is a long form with row after row of medical procedures, types of tests, diagnoses, types of treatment and codes. If the doctor checks the wrong box it can lead to a claim denial. For instance, a woman may be covered for a mammogram for a typical “wellness checkup doctor visit.” But if the doctor checks a different reason for the visit, the insurer might not cover the mammogram.
If the insurance company denies the claim in that instance, you need to get the doctor’s office visit file notes to see just what the doctor wrote in your file. Send the notes to the insurance company along with the explanation of the doctor visit. This one strategy could turn a claim denial into a claim paid.
Strategy #3: Ask for Credentials
Insurance companies use the term “not medically necessary” frequently in denial letters. This is another way of saying a claims processor is questioning your doctor’s judgment. If you get this denial message, call the insurance company and ask for the name and medical credentials of the person doing the second-guessing. Be cordial and polite, and take good notes. Record the conversation. If you find that the credentials of the claim processor are less than your doctor’s credentials, then send a letter to the insurance company, Certified Mail, requesting a medical review by a doctor with appropriate qualifications. For example, if you have a thyroid problem, ask for review by an endocrinologist, not just the insurance company’s medical director, who may have a completely different medical specialty.
Strategy #4: Separate Multiple Services
Multiple medical services that occur on the same day can also lead to a claim denial, especially if the doctor sends the insurance company two separate bills. So a bill from the doctor for reading an X-ray can get confused with the X-ray procedure that happened on the same day. The insurer may see them as duplicate bills and denies one of them...probably the larger of the two. So, get copies of the bills, highlight the separate charges, include a letter of explanation and send it all into the insurer. You might turn a denial into a payment.
Strategy #5: Retain a Patient Advocate
A Patient Advocate is a person or company that
• Organizes the endless bills, statements and claims forms
• Appeals denials of claims and incorrect payments
• Negotiates settlements with medical providers
The Patient Advocate gathers all the medical bills for a patient, analyzes them for accuracy, works with the insurer and medical provider to get the bills corrected, and negotiates settlement of the bills. They can cut thousands out of incorrect bills.
Finally, remember that everything about a medical bill is negotiable. Medical providers constantly accept negotiated amounts as payment in full. Don’t be the guy that “pays retail”...NEGOTIATE!
You can find out more about Patient Advocates at: www.insurancenightmare.com
If you have health insurance through your employer, you’re usually only concerned about the amount of the bills not covered by the insurance. That would be your deductible amount and any co-pays you might have.
But what if some medical procedures are denied? What if some are underpaid? How do you challenge the determinations of the insurance company examiners?
Those bills can be in the thousands of dollars. For more serious illness and treatment, the bills can be in the hundreds of thousands of dollars.
Unfortunately, many of the bills are incorrect...sometimes wildly incorrect. Billing miscommunication happens daily on all levels. Doctor to patient, doctor to coding staff or billing service, billing service to insurance company, and insurance company to patient. Many miscommunications are due to poor interpretation of the facts. The right hand doesn't know what the left hand is doing.
The patient is caught in the middle, doesn't know who to believe, and being the ultimate bearer of the financial obligation, many times just pays the bill out of frustration. There is no average case, all situations are different, and no two problems are the same.
But, what can be done? How can a regular person...an average American faced with giant medical bills...determine the correct medical charges and get correct medical bills?
Strategy #1: Remain calm.
When calling the insurance company to dispute a payment amount or challenge a denial, insist on obtaining the full name of the person you’re speaking to. If they refuse, ask for a supervisor. I also strongly recommend recording every call. When you call into the insurance company, you’ll regularly hear that “this call may be monitored or recorded for quality purposes.” Don’t you believe it. They are covering their butt in case the claim goes into litigation. Get a recording of your own. Make sure you know the law on recording conversations in your state. You can find that information at: www.insurance-claim-secrets.com/support-files/phonerecordinglaw.pdf
Strategy #2: Become aware of “hot spots” in the health insurance billing process that are the source of many errors.
A major source of errors is the “superbill” filled out by your doctor. It is a long form with row after row of medical procedures, types of tests, diagnoses, types of treatment and codes. If the doctor checks the wrong box it can lead to a claim denial. For instance, a woman may be covered for a mammogram for a typical “wellness checkup doctor visit.” But if the doctor checks a different reason for the visit, the insurer might not cover the mammogram.
If the insurance company denies the claim in that instance, you need to get the doctor’s office visit file notes to see just what the doctor wrote in your file. Send the notes to the insurance company along with the explanation of the doctor visit. This one strategy could turn a claim denial into a claim paid.
Strategy #3: Ask for Credentials
Insurance companies use the term “not medically necessary” frequently in denial letters. This is another way of saying a claims processor is questioning your doctor’s judgment. If you get this denial message, call the insurance company and ask for the name and medical credentials of the person doing the second-guessing. Be cordial and polite, and take good notes. Record the conversation. If you find that the credentials of the claim processor are less than your doctor’s credentials, then send a letter to the insurance company, Certified Mail, requesting a medical review by a doctor with appropriate qualifications. For example, if you have a thyroid problem, ask for review by an endocrinologist, not just the insurance company’s medical director, who may have a completely different medical specialty.
Strategy #4: Separate Multiple Services
Multiple medical services that occur on the same day can also lead to a claim denial, especially if the doctor sends the insurance company two separate bills. So a bill from the doctor for reading an X-ray can get confused with the X-ray procedure that happened on the same day. The insurer may see them as duplicate bills and denies one of them...probably the larger of the two. So, get copies of the bills, highlight the separate charges, include a letter of explanation and send it all into the insurer. You might turn a denial into a payment.
Strategy #5: Retain a Patient Advocate
A Patient Advocate is a person or company that
• Organizes the endless bills, statements and claims forms
• Appeals denials of claims and incorrect payments
• Negotiates settlements with medical providers
The Patient Advocate gathers all the medical bills for a patient, analyzes them for accuracy, works with the insurer and medical provider to get the bills corrected, and negotiates settlement of the bills. They can cut thousands out of incorrect bills.
Finally, remember that everything about a medical bill is negotiable. Medical providers constantly accept negotiated amounts as payment in full. Don’t be the guy that “pays retail”...NEGOTIATE!
You can find out more about Patient Advocates at: www.insurancenightmare.com
Health Care Costs: Patient Advocates Can Save You Thousands
You or a family member may have recently had some health care event, such as a hospitalization. Now, over the coming days, the medical bills will arrive at your home. Every medical provider who contributed to your treatment is going to send a bill, and you are the person who bears the financial obligation for payment. If you have health insurance, the insurer may pay a large percentage of your medical bills.
However, an alarmingly large and growing segment of the American population lives each day without health insurance. Insurance experts estimate that over 48 million Americans are living without health insurance. And that number of uninsured persons is expected to increase quickly as the economy worsens and unemployed workers lose their insurance coverage.
When those bills show up after a health care event, a serious financial crisis happens. That patient, or the patient’s family, has to figure out a way to pay those medical bills. Those bills can be in the thousands of dollars. For more serious illness and treatment, the bills can be in the hundreds of thousands of dollars.
If you make mistakes while taking care of these medical bills, you could put yourself in a financial situation from which you could never recover.
Think for a moment how ridiculous the system is for providing medical services. You go to your medical provider for a visit. No one gives you a price list of services. You are not told how much ANYTHING costs while you’re being treated. Usually you find out the cost of your medical services when they present the bill to you.
Would you agree to buy groceries like that? Would you get your car repaired with that kind of billing arrangement? Of course not! You wouldn’t even bury your dead cat without knowing what it would cost!
But, in medical services, ignorance about billing is the accepted method among most consumers.
Sadly, many of the medical bills are incorrect...sometimes monstrously incorrect. Billing errors happen daily on all levels...Doctor to patient, doctor to coding staff or billing service, billing service to patient.
So, what can be done? How can a regular person...an average American faced with giant medical bills...determine the correct medical charges and get correct medical bills?
Retain a Patient Advocate.
Hardly anyone knows about Patient Advocates. You can be sure that the medical providers and insurance companies will NEVER tell you about them.
Why?
Think about it from an insurance company’s viewpoint. If the patient hires a Patient Advocate, and the Advocate does his job, the chances are good that the insurance company will pay more on the patient’s claim.
Think about it from the medical provider’s viewpoint. If the patient hires a Patient Advocate and the Advocate does his job, the chances are good that the medical provider is going to receive substantially less money for his services.
A Patient Advocate is a person or company that
• Will collect all your bills, claim forms and statements, even if they’re in a “shoebox”
• Analyzes the bills
• Submits appeals for incorrect charges
• Negotiates settlements with medical providers
The Patient Advocate can cut hundreds or thousands of dollars out of incorrect bills.
EVERYTHING in a medical bill is negotiable. Don’t be the sucker that pays the bills without making sure they are accurate. Medical providers negotiate their bills with insurance companies EVERY DAY. Why should you pay more?
NEGOTIATE!!
You can find out more about Patient Advocates at: www.insurancenightmare.com
However, an alarmingly large and growing segment of the American population lives each day without health insurance. Insurance experts estimate that over 48 million Americans are living without health insurance. And that number of uninsured persons is expected to increase quickly as the economy worsens and unemployed workers lose their insurance coverage.
When those bills show up after a health care event, a serious financial crisis happens. That patient, or the patient’s family, has to figure out a way to pay those medical bills. Those bills can be in the thousands of dollars. For more serious illness and treatment, the bills can be in the hundreds of thousands of dollars.
If you make mistakes while taking care of these medical bills, you could put yourself in a financial situation from which you could never recover.
Think for a moment how ridiculous the system is for providing medical services. You go to your medical provider for a visit. No one gives you a price list of services. You are not told how much ANYTHING costs while you’re being treated. Usually you find out the cost of your medical services when they present the bill to you.
Would you agree to buy groceries like that? Would you get your car repaired with that kind of billing arrangement? Of course not! You wouldn’t even bury your dead cat without knowing what it would cost!
But, in medical services, ignorance about billing is the accepted method among most consumers.
Sadly, many of the medical bills are incorrect...sometimes monstrously incorrect. Billing errors happen daily on all levels...Doctor to patient, doctor to coding staff or billing service, billing service to patient.
So, what can be done? How can a regular person...an average American faced with giant medical bills...determine the correct medical charges and get correct medical bills?
Retain a Patient Advocate.
Hardly anyone knows about Patient Advocates. You can be sure that the medical providers and insurance companies will NEVER tell you about them.
Why?
Think about it from an insurance company’s viewpoint. If the patient hires a Patient Advocate, and the Advocate does his job, the chances are good that the insurance company will pay more on the patient’s claim.
Think about it from the medical provider’s viewpoint. If the patient hires a Patient Advocate and the Advocate does his job, the chances are good that the medical provider is going to receive substantially less money for his services.
A Patient Advocate is a person or company that
• Will collect all your bills, claim forms and statements, even if they’re in a “shoebox”
• Analyzes the bills
• Submits appeals for incorrect charges
• Negotiates settlements with medical providers
The Patient Advocate can cut hundreds or thousands of dollars out of incorrect bills.
EVERYTHING in a medical bill is negotiable. Don’t be the sucker that pays the bills without making sure they are accurate. Medical providers negotiate their bills with insurance companies EVERY DAY. Why should you pay more?
NEGOTIATE!!
You can find out more about Patient Advocates at: www.insurancenightmare.com
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