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Friday, March 28, 2014

Conspiracy At Work

This one just fell into my lap today.

Say you go into the Urgent Care for really bad bloody nose.  Because they don't have any special nose rooms in the Urgent Care, you get bumped over to the hospital.

After you get treated for you bloody nose, you go home on your merry way.

Later on, it turns out that you get a bill from your medical provider saying that you were diagnosed with aneurysm and that the insurance paid on that claim.

Now, this is a fraudulent claim.

You didn't go in to the hospital with High, Emergency status for an aneurysm.  You went in to the urgent care for a bloody nose.  

Because it's in the system, it's now part of your medical records.

Better yet, no one is willing to change it.

You call the provider and tell them that they have it wrong and have a fraudulent bill.  

They deny it, refuse to change it, and dare you to do something about it.

You call your insurance carrier and tell them that they have paid on a fraudulent claim.  

They don't care.  

You press them for doing an audit against your medical records.

They offer you a compliant form to fill out.  

Once you make the claim, however, you're not allowed to find out what the status of that claim is- ever because it's a complaint per Medica Passport customer service "between the insurance provider and the medical provider". 

When I brought up the non-sequetor there (uhm, it's between all three of us and you're supposed to be on my side), they said that's how it is.

So, medical providers and medical insurers have a really nice little business going here.  They write up whatever the F they want and then the insurance pays it- no questions asked.  And you have to pay the deductible of whatever the F they decided to write into the computer.

Seriously, people, HOW LONG ARE WE GOING TO PERMIT THIS MODERN AGE OF ENSLAVEMENT?


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