Doctor’s Diary October 27, 2017: In Denial

(Snippets from the frontline)

In Denial

You suddenly become ill.  The emergency room doctor feels admission is necessary.  Your physician agrees, so you are hospitalized with IVs and testing done.  Treatment is given, you survive and go home.

Your insurance company denies payment and claims you should not have been admitted.  Now you are responsible for all medical bills.

Denial by insurance companies after hospitalization happens more frequently each day.  Occasionally, your physician can have a “Peer-to-Peer” phone discussion with the insurance doctor to mitigate the issue. 

Here’s the rub:  They decide on an “approximate” call time (e.g. 8-12 noon), and expect your physician to be around a computer to reference the medical chart.  If this contact is not made within a certain number of days from discharge (sometimes as little as three), their denial automatically becomes irreversible.

Trying to allot “Peer-to-Peer” time is like waiting for cable TV repair.  Your doctor is under the gun and gets blamed.  Worse, it is time infringement on medical care rendered to other patients.

It’s a new twist in their old game.

Another reason for eliminating insurance company middlemen.

Gene Uzawa Dorio, M.D.


  • Steve Kassel says:

    This is another reason to send insurance companies to Guantanamo. The families and lives they destroy with arbitrary rules intended for more profits is cruel and vulgar. My European friends, family and colleagues do not live with this kind of fear and vigilance. Its time for Congress to “promote the general welfare” and bring in Medicare for All.

  • Sally White says:

    Very important information that all need to have!
    Thank you!

  • George Vergara says:

    Dr Dorio; very informative. I was not aware of these barbaric tactics from insurance companies. I appreciate the information.

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