https://mas.to/@MikeBeas/113666556469008087
EDIT: I think you should get the service you pay for, just so that's clear.
this post was submitted on 18 Dec 2024
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They actually hire doctors to analyze claims and they're the ones making the decisions whether the claims are accepted or not.
I'm sure the doctors stick with reviewing claims for which they have a lot of experience, spend the time to actually review the patient's specific scenario better than the doctor who saw the patient, and aren't financially incentivized to deny as many claims as possible.
Shouldnt a doctor be "reviewing" the patient before making decisions?
Like wtf is is this middle manning. You go see doctor, then another insurance doctor is checking his homework but only based on paper work and with a financial incentive to deny as many claims as possible.
Also, I bet they explicitly state they are not rendering care when they review a claim, CYA legal shit. So are they even acting in their capacity as medical professional or just paper pusher with an MD. I don't think it even requires a licese.