| There is little or no doubt that the Health | | | | Example: I was asked to consult on a hospitalized |
| Insurance Industry has a strangle hold on doctors | | | | patient because she was passing blood and in pain |
| and other healthcare providers and the delivery of | | | | due to a kidney stone. Imagine my surprise when |
| healthcare. There may be little hope as a | | | | my claim for payment was denied for pre-existing |
| significant number of these health insurance | | | | condition. The insurance company claimed that the |
| companies get richer and richer; their buildings get | | | | stone was pre-existing! |
| taller and taller and they become more powerful | | | | Abuse #2: Referral or Prior Authorization |
| political lobbyists. CEOs may command six or | | | | It is my opinion that the practice of insurance |
| even seven figure salaries. In a significant number | | | | companies mandating that healthcare providers |
| of cases, bonuses grow and flourish as life-saving | | | | get special permission (referrals or prior |
| or health preserving medicines and care are | | | | authorizations) should be banned. These referrals |
| denied. This series of articles will focus on the | | | | or prior authorizations may be imposed on a |
| abuse inflicted on healthcare providers and the | | | | healthcare provider before he or she can give a |
| healthcare system by a significant number of | | | | patient a health preserving medicine, diagnostic |
| health Insurance companies. "The nation's HMOs | | | | test, hospitalization or even an office visit. |
| reported a $3.6 billion profit for the first three | | | | Referrals or prior authorizations in too many |
| months of 2005, representing a $646 million, or | | | | cases delay care and may place a patient's health |
| 21.4 percent, increase over the $3.0 billion earned | | | | in jeopardy. They are barriers to care and in |
| during the first quarter of 2004" according to | | | | many cases are used as weapons to deny care in |
| Weiss Ratings, Inc. | | | | order to line the pockets of the insurance |
| Abuse #1: Pre-existing Condition. | | | | company. Isn't it silly to think that healthcare |
| Patient walks into a doctor's office to be seen and | | | | providers who have spent many years in training |
| he or she presents his or her health insurance | | | | and are indeed experts can't determine on their |
| card. The staff verifies insurance coverage and / | | | | own if a patient needs to be seen or is in need of |
| or obtains a valid referral (permission) from the | | | | a medicine or test. |
| insurance company to see the patient. The patient | | | | Example: A patient presented to my office just |
| is seen to take of the concerning health problem. | | | | after closing. I had seen her in consultation in the |
| The insurance company is billed. The doctor's claim | | | | past for uncontrolled high blood pressure. She was |
| for payment is denied. Pre-existing condition is the | | | | not feeling well and she complained that her blood |
| reason given by the insurance company. In other | | | | pressure was elevated. The insurance company |
| words this condition started before (pre-existed) | | | | was closed so we could not get a referral |
| the insurance coverage. However, a doctor | | | | number. I obviously saw the patient and |
| cannot know this unless he or she first sees the | | | | administered medicine to reduce her blood |
| patient and takes a history. The doctor or other | | | | pressure. She felt better. I also prevented a |
| healthcare provider may never get payment. The | | | | needless emergency room visit. The next day we |
| patient despite paying premiums may get stuck | | | | called the insurance company to explain our |
| with the bill. The insurance company pockets this | | | | situation and they said they would deny our claim |
| money. The fight is on. Guess who usually wins, | | | | since we saw her without permission. |
| the company in that 20 or 40 story plush | | | | Healthcare providers and patients must speak up |
| corporate office building that has enough red tape | | | | and demand that our elected officials make health |
| to tie up the healthcare provider for months to | | | | insurance industry reform a priority. |
| come. Guess who usually gives up. | | | | |