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Started By
Message
re: Anthem Blue Cross Blue Shield calls off surgery anesthesia cap
Posted on 12/5/24 at 7:01 pm to wackatimesthree
Posted on 12/5/24 at 7:01 pm to wackatimesthree
quote:
This was to stop overbilling by the anesthesiologists.
You don’t think they should be paid for their time beyond what the insurance company says is allowed? Just waste hours of time away out of the goodness of their hearts? Time away from family and other interests? What about after hours, weekends, holidays? Should they be paid for all the time they are working on Christmas at least?
1
Posted on 12/5/24 at 7:03 pm to Major Dutch Schaefer
Sounds like someone received a message
Tell me something. If 1 CEO has to die for hundreds of millions to benefit...how many people are gonna take that deal?
Tell me something. If 1 CEO has to die for hundreds of millions to benefit...how many people are gonna take that deal?
Posted on 12/5/24 at 7:05 pm to Hester Carries
quote:
However, you have basically just emboldened violent vigilantes.
Posted on 12/5/24 at 7:07 pm to Major Dutch Schaefer
quote:
The CEO does not want the treatment the the United Healthcare CEO received.
Violence is a great motivator, shocker.
Posted on 12/5/24 at 7:07 pm to Lawyered
quote:
Healthcare in America is such a freaking scam
And we subsidize every country on earth. They get cheap everything and we pay for them to get it cheap.
Posted on 12/5/24 at 8:41 pm to Major Dutch Schaefer
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This post was edited on 12/5/24 at 9:43 pm
Posted on 12/5/24 at 10:54 pm to BeaumontBengal
quote:
You don’t think they should be paid for their time beyond what the insurance company says is allowed?
What I think is that they were likely lying about the time.
This sort of thing happens all the time.
When you go to the primary care doctor and they spend five minutes with you in the room, ask you some questions, listen to your heart, listen to your lungs, and then bill a 4 Level exam code, they are lying.
Billing a 4 level exam code requires between 30-39 minutes of face time WITH THE DOCTOR. Not five minutes with the MA, ten minutes with the nurse, five minutes with the doctor, and another ten minutes between the MA and the front desk.
Does nearly everyone do it? Yes.
Is it so common that insurance companies pretty much universally look the other way for this particular code even though they KNOW that the requirement aren't being met? Yes.
But that's my point.
Those of you who are viewing this as outsiders do not understand that this is a game, and you don't understand how the game is played. Neither the insurance company nor the provider are playing the game honestly. There is no good or bad guy in this game.
They are constantly lying to each other and wrestling over money while sufficiently staying within the ditches (usually) to the point that you are still able to get some medical help.
Trust me on three things:
1. You don't know what you're talking about here.
2. I do, at least to a much greater degree than you.
3. This one was the fault of the anesthesiologists, not the insurance company. Tomorrow it may be the insurance company at fault, but today, on this issue, it's the anesthesiologists.
This post was edited on 12/5/24 at 10:56 pm
Posted on 12/6/24 at 7:35 am to wackatimesthree
quote:
What I think is that they were likely lying about the time.
How can one lie about the operating room time? That time is documented on the nursing and hospital documentation as well as the anesthesia bill. You think the insurance company would let them commit fraud when it’s that easy to check other documents?
quote:
Trust me on three things: 1. You don't know what you're talking about here. 2. I do, at least to a much greater degree than you.
I’m an anesthesiologist. You don’t know what you are talking about.
Posted on 12/6/24 at 7:38 am to BeaumontBengal
quote:quote:
Trust me on three things: 1. You don't know what you're talking about here. 2. I do, at least to a much greater degree than you.
I’m an anesthesiologist. You don’t know what you are talking about.
Absolutely demolished
Posted on 12/6/24 at 7:39 am to BeaumontBengal
lol oops
Posted on 12/6/24 at 7:52 am to wackatimesthree
I understand and see your original argument about the four-level exam code and how insurance and medical companies manipulate the system in that context. However, blaming the anesthesiologist for this scenario doesn’t hold up—how could they possibly be responsible for how slow a surgeon operates? Besides, it’s well known that nurse anesthetists handle most of the workload anyway. So yeah, maybe anesthesiologists should be doing more to earn their money, considering they’re mostly just ‘watching’ professional anesthesia providers do the actual work.
Posted on 12/6/24 at 7:57 am to Ingeniero
quote:
Absolutely demolished
He won't be back
Posted on 12/6/24 at 8:16 am to Lawyered
quote:
Healthcare in America is such a freaking scam
Always has been but at least you can keep your doctor.
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