(Snippets from the frontline)
Intentional confusion
As a senior on Medicare, I received my first EOB (Explanation of Benefits) for a doctor visit. It was like attempting to make sense of a cable or cell phone bill, and as challenging as deciphering hieroglyphics.
Whether it be Medicare, insurance companies, or hospital and pharmacy bills, making heads-or-tails of calculations are hopeless. There are codes, groups, categories, brackets, and generic names complicating the paperwork unleashing mental anguish and resulting in a bottom line you now owe to the provider.
It is intentional confusion.
For years, insurance companies denied reimbursing physicians without reason, hoping the doctor would cease submitting bills. Now these companies do the same thing to patients, with the thought you will also give up and just pay it.
So at one end they don’t pay the doctor, and at the other end, they get patients to pay out-of-pocket. Insurance companies are shysters not providing medical service, yet still acting in the middle profiteering and skimming money to the detriment of patient care.
Removing middlemen would improve the quality of healthcare and might eliminate intentional confusion.
Gene Uzawa Dorio, M.D.
My former office manager used to work for an insurance company close to 40 years ago, before the era of computer billing. She was told to throw away about one in every 20 paper claims with the thought that the doctors’ office staff would not rebill. If the office called, they were told by the insurance company that they never received the claim. Funny, the insurance company never ‘lost’ a premium check.
Some things never change.
Yes what a mess medical insurance makes of our lives !!! Now insurance companies automatically deny special testing for extreme health conditions. My insurance statement does not even put the test name of procedure just a code number!!!