posted
These insurance corporations are nothing more than sleazy mobsters....
The Department of Managed Health Care has fined Blue Cross of California $1 million for "routinely" rescinding individual health insurance policies of chronically ill or pregnant enrollees, in violation of state law.
The fine was based on a random survey of 90 terminated individual policies from January 2004 through January 2006, DMHC officials said Thursday. It was conducted after the agency received complaints from Blue Cross enrollees that their policies were canceled after they submitted a claim or received medical treatment. Such cancellation can make it difficult for consumers to obtain new coverage.
Blue Cross is a subsidiary of Indianapolis-based WellPoint Inc. (NYSE: WLP).
posted
For these scumbags, fines are looked at as just a cost of doing business.
I guarantee you that they made a hell of a lot more than a million bucks by doing this.
glassman
posted
it is pervasive in the medical "business"...
you should all familiarise yourselves with this:
8 most common hospital billing errors
Don't let hospital billing departments pull these -- like charging you for two appendectomies -- on you. It's an outrage. By Bankrate.com
Make no mistake about it: Making sure that all the charges on your hospital bill are justified and reasonable is a formidable undertaking. But it can be easier if you know what to look for.
Here are the most common areas of overcharges and errors, plus what to do if you find irregularities.
Duplicate billing: Make sure you haven't been charged twice for the same service, supplies or medications.
Number of days in hospital: Check the dates of your admission and discharge. Were you charged for the discharge day? Most hospitals will charge for admission day, but not for day of discharge.
Incorrect room charges: If you were in a semi-private room, make sure you're not being charged for a private.
Operating-room time: It's not uncommon for hospitals to bill for more time than you actually used. Compare the charge with your anesthesiologist's records.
Up coding: Hospitals often shift the charge for a lower-cost service or medication to one that's more costly. For example, a doctor orders a generic drug, but the patient is charged for a pricier brand name.
Keystroke error: A computer operator accidentally hits the wrong key on a keyboard. It can cost you hundreds of dollars and result in an incorrect charge for a service you didn't get.
Canceled work: Your physician ordered an expensive test and then canceled it, but you were charged anyway.
Services never rendered: Did you get every service, treatment and medication for which you are being billed? Here's where your log will come in handy.
Professional bill reviewers can help If you find errors, contact your provider's billing office and your insurer. If they are of no help and the discrepancies are significant, you may want to turn to trained professionals who will help you analyze the bill and negotiate for you.
"These professionals have sprung up because there are so many errors," says Bill Mahon of the National Health Care Anti-Fraud Association. "They are saving people money, and sometimes it's a lot of money."
Medical Billing Advocates of America is one of them. Based in Salem, Va., it operates in 18 states and the District of Columbia. These firms frequently work on a contingency basis, meaning they get paid a percentage of the amount they save you. But that percentage often runs as high as 50%, so make sure you understand their charges before you put them to work
posted
Had a lazer hernia operation years ago. The insurance company caught it when the dr and the various assistants and the hospital all tried to charge for two operations.
Afterward, the damned drs kept comming at me to "make up the difference". Where they do it most (and too often get away with it) is with medicare and medicade.
In almost all casses, the medical profession is far more interested in charging fees than in curring ills.
Gordon Bennett
posted
The medical "business." What a sick construct...
Blue Cross of California fined $1 million for 'illegally' canceling policies Sacramento Business Journal - March 23, 2007
i understand your concern, but GB's posting pattern is consistent...
this topic does fit within his normal parameters....
Gordon Bennett
posted
I'm topical, aren't I!
bdgee
posted
quote:Originally posted by Gordon Bennett: I'm topical, aren't I! :D
Yup, just like preperation H at times, Gord....
Gordon Bennett
posted
LOL
Gordon Bennett
posted
Why would they ever want to cure anything?
Like any big business, they want you to continue to use their "product."
It's a sick system...
quote:Originally posted by bdgee: Had a lazer hernia operation years ago. The insurance company caught it when the dr and the various assistants and the hospital all tried to charge for two operations.
Afterward, the damned drs kept comming at me to "make up the difference". Where they do it most (and too often get away with it) is with medicare and medicade.
In almost all casses, the medical profession is far more interested in charging fees than in curring ills.
glassman
posted
my wife worked in medical billing office for a big hospital (billing was contracted out) while she was working on her masters...
she saw this stuff first hand... it's bene going on for decades...
Gordon Bennett
posted
We have all been taught "the insurance will take care of it." Very few people even look at their bills, probably.
Gordon Bennett
posted
The insurers get rich while we slip further into substandard care.
Gordon Bennett
posted
The next president had better address this.
urnso77
posted
He or She won't. Long live the evil insurance companies!!
bdgee
posted
Yhere is no doubt it will be a MAJOR concern during the commong campaign.
Edwards has already begun formulation plans for the government to attack the problem. I'm sure he isn't the only smart one.
Gordon Bennett
posted
The insurance criminals will get justice soon...
posted ![[Big Grin]](biggrin.gif)