Once again it is clear that the health insurance industry has become an investment oriented enterprise, divorced from the true intent of insurance (globally shared risk). Because they have become ‘premium retention arbitragers’, their goal is to hold on to the premium dollars they have on deposit at all costs. One easy way to do this is to deny and delay payment to physicians and other health providers. This stalling tactic, long recognized by providers and hospitals, is well known and routinely practiced. It is to be condemned fully. Insurers love to trot out misdeeds by a small minority of providers to justify their behavior, but in fact they treat all providers the same – with disrespect, with suspicion and in many cases with outright disdain. Only health insurance reform can lead to Real Health Reform . . . jomaxx
AMA calls physician reimbursements flawed
Failings by insurers and Medicare add more than $200 billion a year to the nation’s healthcare tab, report says.
Insurance companies often fail to properly reimburse doctors, needlessly adding more than $200 billion a year to the nation’s healthcare tab, the American Medical Assn. said Monday. An analysis of 3 million medical claims over a six-month period beginning in October also found that doctors in the U.S. spend 14% of the fees they receive from insurers and Medicare on the process of collecting those fees, the AMA said in a report issued at its annual meeting in Chicago.
The analysis sized up insurers and Medicare on how often they paid on time, how often they denied claims and how often they paid at the contracted rate and other measures.