I have described how the healthcare insurance industry loads its expenses into direct patient care expenses to increase their profits.
The Medical-Loss Ratio calculation is not reported by the traditional media. The healthcare insurance industry spends less healthcare dollars on direct patient care after it is permitted by federal and local agencies to load its expenses into the direct patient care column.
Simply put, the healthcare insurance industry cooks the books to increase its net profit.
Another way to increase profits is to shortchange physicians on medical claims. In fact, 20% of medical claims payments are inaccurate according to the American Medical Association’s (AMA) fourth annual National Health Insurer Report Card. Claims-processing errors by health insurance companies waste billions of dollars and frustrate patients and physicians.
This is one of the reasons the RAND report about physicians controlling waste is so absurd to me. The healthcare insurance industry creates waste in order to increase net profit. Read more »
*This blog post was originally published at Repairing the Healthcare System*
Call it sweet, delicious vindication. It was clinic day yesterday. No longer had I completed my rant in this blog about UnitedHealthcare’s program to require all cardiac elecrophysiologists to obtain a “notification number” before performing any pacemaker or defibrillator procedure, I discovered my letter from them dated June 3, 2010, on my desk stating that this requirement will begin September 1, 2010, for all Illinois electrophysiologists for “all electrophysiology procedures.”
Not longer than an hour later I was seeing a 67-year-old patient in the clinic who asked me: “I just got my Medicare (Part A) card and must decide about which insurer I should use for Part B, C, D, E, and F,” he said jokingly. “Since I have the medical problem and might need some care in the future, is there a company you would recommend?” Read more »
*This blog post was originally published at Dr. Wes*