Wednesday, August 22, 2007
United Health Care: Mind boggling stupidity
My Health Care provider is United Health Care – UHC, for short. I have previously had no problems with them. But this year, I suffered a partially torn rotator cuff and went to an Orthopaedic Specialist. He sent me for x-rays and an MRI, the latter of which revealed the injury. He also recommended me for Physical Therapy.
UHC were billed $3,620 for the therapy and paid $1,171.04. I paid $20 for each of my 16 visits. For the tests, $3,050 was billed and $1,682.28 paid. These are group rates and I owed nothing. The Specialist billed a lot for the consultation and follow up: $500 and $150 respectively. The Insurance didn’t pay a penny, claiming that the doctor supplied insufficient documentation for the level of care provided.
I found out today that they have a new rule that Orthopaedic Specialists must provide a full Orthopaedic report to the Insurance Company in order to get paid. But they had no problem paying $2,853.32 for Diagnostics and Therapy for an injury that the Specialist supposedly insufficiently proved.
Can anyone else see the unparalleled stupidity of this? I can imagine a bunch of officious, pen-pushing prigs with no more medical knowledge than you or I, trying to come up with yet more inventive and annoying ways to ‘show the doctors who is really in charge’. I would far rather give money to a Doctor than to these parasites. I fart in their general direction!
A further example of their stupidity: I was diagnosed about a year ago with borderline high cholesterol. I have had hypo-thyroidism for some years now. Each of these need blood tests, but the former more frequently than the latter. In February, I had the cholesterol test and accompanying Liver function test (cholesterol medication can cause kidney problems). Lenco Diagnostics charged $1,300 for these and UHC paid them $650. In July, I had these plus the Thyroid test. Labcorp charged $255. UHC paid only $41.27. 15 times more money for 2/3 of the tests? Apparently makes sense to someone!!
Life and dealing with Government Agencies has taught me not to expect logic where I used to hope to find it. But this is a step too far into the Twilight Zone. Surely, if you had told an American doctor in the 1960’s what they would have to deal with now, that is what they would have thought was being described. When is the Government going to step in and make some sense of this nonsense!!!
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UHC were billed $3,620 for the therapy and paid $1,171.04. I paid $20 for each of my 16 visits. For the tests, $3,050 was billed and $1,682.28 paid. These are group rates and I owed nothing. The Specialist billed a lot for the consultation and follow up: $500 and $150 respectively. The Insurance didn’t pay a penny, claiming that the doctor supplied insufficient documentation for the level of care provided.
I found out today that they have a new rule that Orthopaedic Specialists must provide a full Orthopaedic report to the Insurance Company in order to get paid. But they had no problem paying $2,853.32 for Diagnostics and Therapy for an injury that the Specialist supposedly insufficiently proved.
Can anyone else see the unparalleled stupidity of this? I can imagine a bunch of officious, pen-pushing prigs with no more medical knowledge than you or I, trying to come up with yet more inventive and annoying ways to ‘show the doctors who is really in charge’. I would far rather give money to a Doctor than to these parasites. I fart in their general direction!
A further example of their stupidity: I was diagnosed about a year ago with borderline high cholesterol. I have had hypo-thyroidism for some years now. Each of these need blood tests, but the former more frequently than the latter. In February, I had the cholesterol test and accompanying Liver function test (cholesterol medication can cause kidney problems). Lenco Diagnostics charged $1,300 for these and UHC paid them $650. In July, I had these plus the Thyroid test. Labcorp charged $255. UHC paid only $41.27. 15 times more money for 2/3 of the tests? Apparently makes sense to someone!!
Life and dealing with Government Agencies has taught me not to expect logic where I used to hope to find it. But this is a step too far into the Twilight Zone. Surely, if you had told an American doctor in the 1960’s what they would have to deal with now, that is what they would have thought was being described. When is the Government going to step in and make some sense of this nonsense!!!
