One in five insurance claims is denied. Fewer than one in a hundred ever appealed. The system does not need to be correct. It only needs you to be exhausted.
As someone who truly believes our health care system is broken, I read your opening paragraphs with great interest. But a few seconds in I stoped. Something didn’t feel quite right. How does a guy with the title “VP of Claims Optimization” at UHC still have a job after posting this? So I researched your name. Is the Senior Threat Researcher from Austin a different person? Or is your very first sentence a (to be generous) a fiction?
"Insurance fraud" is a redundancy. If an insurer takes your money in return for future promises to pay for your expenses, and then your expenses come up and they refuse to pay, that is fraud. And that is the entire business model of virtually every insurer.
Thank you for this honest explanation. I’ve fought my own battles with the medical industrial complex for the past 43 years. It’s such BS. I’ve advised many to NEVER
pay their med bills in full. ALWAYS negotiate. The crime perpetuated against uninsured or self-pay is, well just plain criminal but I learned that 43 years ago also.
Then there’s the simple fact that we expect and receive an itemized receipt from every fast food joint drive-through, but NEVER get one from a hospital or medical provider except “codes” which of course are bundled charges that hide and subvert the true cost. Oh, but many of these medical
Facilities operate as not-for-profit don’t they? Yep - they screw us 1000 percent or more then screw us again with the tax status. And subpar care. That’s why I have avoided white coats for over a dozen years.
I can only believe that you are sleeping better at night with these public revelations, but are you also exposing it and aiding in changing the system? Hope so. You shouldn’t have to work after rolling in all the dough due to your expertise in screwing consumers. Sorry - not sorry - I know you were doing your job, but at some point a good person stands up against evil. You’ve gotten a good start in that regard and I
As someone who truly believes our health care system is broken, I read your opening paragraphs with great interest. But a few seconds in I stoped. Something didn’t feel quite right. How does a guy with the title “VP of Claims Optimization” at UHC still have a job after posting this? So I researched your name. Is the Senior Threat Researcher from Austin a different person? Or is your very first sentence a (to be generous) a fiction?
"Insurance fraud" is a redundancy. If an insurer takes your money in return for future promises to pay for your expenses, and then your expenses come up and they refuse to pay, that is fraud. And that is the entire business model of virtually every insurer.
Thank you for this honest explanation. I’ve fought my own battles with the medical industrial complex for the past 43 years. It’s such BS. I’ve advised many to NEVER
pay their med bills in full. ALWAYS negotiate. The crime perpetuated against uninsured or self-pay is, well just plain criminal but I learned that 43 years ago also.
Then there’s the simple fact that we expect and receive an itemized receipt from every fast food joint drive-through, but NEVER get one from a hospital or medical provider except “codes” which of course are bundled charges that hide and subvert the true cost. Oh, but many of these medical
Facilities operate as not-for-profit don’t they? Yep - they screw us 1000 percent or more then screw us again with the tax status. And subpar care. That’s why I have avoided white coats for over a dozen years.
I can only believe that you are sleeping better at night with these public revelations, but are you also exposing it and aiding in changing the system? Hope so. You shouldn’t have to work after rolling in all the dough due to your expertise in screwing consumers. Sorry - not sorry - I know you were doing your job, but at some point a good person stands up against evil. You’ve gotten a good start in that regard and I
thank you for that.