A worker in a health care provider’s office told me this story. It explains a lot.
A medical provider rendered services to a patient in 2008, and subsequently submitted a claim to the insurance company, which paid it.
In 2010, the insurance company decided to not pay for the service because the patient had other insurance coverage.
The provider had to go prove to the insurance company that the patient had no other coverage.
The provider resubmitted the claim to the insurance company.
The insurance company rejected the claim because it was not submitted in a timely manner!
The provider noted to the insurance company that it had PAID the claim two years earlier, then rejected the claim in error.
The insurance company finally paid – again.
I know this story is true because another provider is dealing with an insurance company that is claiming my wife has additional coverage, something she did actually have, but cancelled three years ago.
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Take Out Some Insurance On Me, Baby (Uncensored) – The Beatles featuring Tony Sheridan.
One of the criticism of the health service in the UK is its high management and adminstration costs, but I would be interested to know what the percentage is in the US, including the health insurance companies.
Hey there Parrots – The usual conservative figure quoted by advocates of Single Payer Health is that Single Payer would eliminate one third of administrative costs. Some say half and still others say two thirds. A single administrative entity would drastically reduce duplication of paperwork and the associated costs. That alone makes Single Payer worthwhile from a taxpayer’s point of view.
Since you are in the UK, you will probably be surprised to learn that competition between health providers is driving US health costs into the stratosphere and is denying essential health care to, believe it or not, a majority of the population.
You see, instead of one big government bureaucracy that is somewhat accountable to elected officials like you have, we’ve got thousands of predatory corporate bureaucracies, each and every one of which is devoted first above all else to making a profit (The Bottom Line, their god.) Not a single one of these health bureaucracies is accountable to anyone but themselves. We US health consumers have to provide profit for all of these outfits whether we like it or not.
And yes, thanks to inappropriate privatization of this sector of our society, millions of formerly solvent Americans are going broke and dying unnecessarily. That’s right, millions. The stories Roger related above are all too common.
So next time you complain about your big cumbersome government health system, cheer up. Believe me, it could be a lot worse.