Thursday, October 12, 2006

How the Grinch Stole Health Care

I need a certain medical test. Nothing life threatening. At least, not at the moment. My doctor wants me to take the test because she needs a baseline to go by so she can watch and see if there are any changes in the future. Unfortunately for me, and thousands like me, it is no longer a doctor's decision as to whether a patient needs a test. It is up to the insurance company. The insurance companies are now farming out all requests for tests to a company called CareCore whose only function at the moment is to reject the claim. Or rather, not reject it outright, but to demand more and more information in the hopes that the party involved will either give up and forgo the test or just pay for it without going through insurance. I guess the insurance companies think patients are going through these tests for fun, subjecting themselves to doses of radiation and the indignities of medicine just for the hell of it. I wonder who actually works for CareCore? Do they really have enough medical knowledge to make these decisions? It's sad that our lives are now being controlled by the insurance company.


Anonymous said...

Do you use GHI? I haven't had problems like that. Yet, at least.

Pissedoffteacher said...

This wasn't my first problem with them. A few years ago, my son needed jaw surgery because he couldn't open his mouth more than 1/2 inch. GHI rejected the surgery so many times that the paper and stamps alone could have paid for surgery. We finally got it approved 4 days before the scheduled surgery. My husband has United Health Care. They approved it in minutes. Unfortunately, I was the primary insurance so we had to wait.

GHI is never a problem until you need something special. The receptionist is the doctor's office told me they are the worst of all the insurance companies.