No one expects that.
My employer-subsidized insurance is through Regence, but Optum manages my FSA. Every now and then they’ll send me a letter, seemingly at random, demanding documentation for one of my prescription refills, as if they can’t figure out why I would possibly be using my card at the pharmacy counter.
It’s quite annoying.
I’ve had to bounce between insurers ever 2-3 years because my company keeps switching and the other option of Kaiser continues to try to collect on a supposed debt that their medical side acknowledges to be obviously misattributed (as I have not and will never require “neonatal care”) and they all seem pretty awful, although I will say that the decade or so ago when I had some form of Blue Cross/Blue Shield/Anthem was not terrible. Now I have Cigna, and even the approved urgent care facilities are only staffed by nurse practitioners, so I’m basically at the point of stitching up my own wounds and ordering veterinary-grade antibiotics for anything less than compound fractures or a sucking chest wound.
Stranger
Luigi isn’t a kook? That’s news to me.
I’m not a fan of United Healthcare, and I’m DEFINITELY not a Trump fan. I do not celebrate either event, on any level.
So your big problem with Cigna is that the in network urgent cares are staffed by NPs?
Personally an NP sewing up a laceration for me would be fine. I’m not particularly trusting of care in an urgent care in general but that goes for the docs too.
Around here, if you need to see your primary care giver, you are looking at a 2-3 month wait. Used to be if I had a bike wreck and needed to have wounds clean, I could get in right away. Now I am referred to urgent care and they don’t even clean the wounds…just take a look and tell you to clean up and bandage on your own and send you on your way. I’ve had two bike wrecks in the last year’ish and it’s unbelieve to experience the lack of medical care we are experiencing in the US right now. I did get x-rays to make sure there were no broken bones (minor rotator cuff tears but super painful AC joint separations) but no real treatment. “Schedule a follow-up with you PCP”.
Of course, you could always pay many hundreds out of pocket to go to the ER for non-life threatening care, but I’m not sure that would even be worth it.
What’s funny about that is my current employer offers several different providers/plans, and United is the most expensive/luxurious one they offer (I’ve had staff at my doctor’s offices comment on how good my particular insurance is). I’m honestly pretty happy with them, but I assume that all United Health Care plans aren’t created equal. If the UHC plans available were one of the less expensive plans or maybe if I had more severe health problems, I think that I probably would be less satisfied.
Actually my major problem with Cigna is that nobody seems to want to work on their plans because apparently they have a real problem making timely payments (because medical insurance companies are apparently just as good as fucking over independent practitioners as they are patients); the list of available physicians they gave me to find a new PCP was at least five years out of date and about 95% of GPs I contacted said that they are no longer accepting that insurance. And they are reportedly one of the ‘better’ carriers. WTF?
I’d actually be okay with an NP suturing up a minor wound but I honestly don’t see the point unless it is on my back or somewhere else I can’t reach because I have enough experience cleaning lacerations and applying closures that I can probably do it just as well as they can. But when it comes to diagnosing infectious disease or dealing with potentially more serious injuries I’d prefer to have at least a PA doing the work because my WFR and ETR training basically stops at setting bones and stopping critical bleeds (hopefully only on other people).
It took me over four months for an initial consult with a new PCP who did little more than take a look at the vitals his medical assistant took and ask me who I favored in whatever sportsball game was coming up, and then ordered a standard test panel instead of doing any kind of detailed medical history and examination for the nerve issue I came in to address, and then scheduled a ‘telehealth’ call six weeks out. When the lab screwed up the bloodwork I basically just said “Fuck it,” because I was already out $300 in copays to basically be told “Take two aspirin and call me in a month,” and the issue ended up spontaneously resolving.
I’m dreading the day I have to do something about my persistent shoulder dislocation issue because I can imagine the string of specialist recommendations, justifications, rejection and arbitration, and whatever else is involved in treating that so I’m doing all of the prehab/rehab I can do with indian clubs and kettlebells to strengthen the muscles and tendons, avoiding pullups and handstands, and hoping to keel over in the next pandemic or natural gas explosion before it becomes a disabling condition. But fortunately, it’s only on my second favorite arm.
Stranger
If it was the NP I see at my oncologist’s clinic, sure. If it was the NP I know personally who got her degree online and (spoilered for incendiary content) believes that Sandy Hook was a ruse to get guns confiscated by mobs of Obama’s minions going door to door, and also believes that public-school teachers take girls to get abortions during the school day without their parents’ knowledge or consent , nope, nope, nope. I like her, but I wouldn’t want her treating me for anything.
I couldn’t get good help for my first shoulder injury but finally got in to PT for my second (both shoulders injured at this time) and finally got some treatment that helped. Having both shoulders injured = no sleep. I have now finally recovered and I’m able to do strength training again and hopefully keep them in good shape. The moral of my story is do not fucking crash on your bike once you are over 50.
My left shoulder still binds up fairly bad when driving and doing things where my arm is straight out, but I have to live with that.
Anecdotes are not data, but the UHC has a bad reputation among health care providers while Kaiser has a fairly good reputation. So I think the chart is telling us something. Whether it’s telling us everything is another matter.
I’m dubious. NYC has a small number of radicals who like putting up posters. Bloomberg reported that the cops are investigating them, but naming Goldman Sachs and other financial firms suggests the usual suspects are wheat pasting, not a new group of people. Incidentally, the names of the firms plastered on NYC walls have been scrubbed off the Bloomberg article, suggesting that the system is defending itself fairly well. I approve.
Here’s a fun chart, via Kevin Drum:
Some insurers have a claim denial rate approaching 50%; others are at 3 or 4 percent. That’s quite a range.
Looks like another CEO got visited by three ghosts overnight.
I’ll try to be more clear. There was no mystery behind who the would be Trump assassin was as he was identified very quickly. Nobody knew who Luigi was for a few days after he made national news. All we knew was that he killed the CEO of a company in an industry that is widely reviled, but otherwise he was a blank slate. A tabula rasa many people used to build their own hero out of. After he was identified, like most assassins, it turns out he’s just a kook.
And now a woman in Florida, Brianna Boston, has been charged with terroristic threat for ending a phone call Tuesday regarding a denied claim with: “Delay, Deny, Depose. You people are next.”
BlueCross BlueShield, acting without delay, contacted the FBI, who coordinated a visit to Boston’s home by Lakeland, Florida police later that day.
She told the officers “because it’s what is in the news right now” and that she learned about them from the Thompson killing. Police said she added that she does not own a firearm and “was not a danger to anyone.”
In Florida-woman fashion, she had the right to remain silent, but not the ability: “Yeah that’s exactly what I said but I didn’t mean anything by it’,” Lakeland Police Chief Sam Taylor said. “Well, you don’t get to pull that back after you say it.”
Boston was arraigned on a $100K bond, and is facing a 15-year sentence on what would be her first criminal conviction. A financial support find was promptly shut down by Gofundme.
Golly, who says the system doesn’t work?
A nit, on terminology.
United Healthcare, as a health insurance company, is not actually a health care provider; they are an insurer (or, to use an industry term, “payer”). The term “provider” is properly used for individuals and companies which actually provide healthcare services: doctors, clinics, hospitals, etc.
When we talk about claims denials, those denials aren’t being made by the providers; they are being made by the insurers.
(That said: United Healthcare muddies the waters a bit, because their parent company also owns a provider network.)
My cite: I work in advertising, and have had health insurance companies as clients for most of the last 20 years. My clients have always made it clear to us that we should never use the term “healthcare provider” in reference to them, as that is not what they are.
I read that as " providers (doctors/hospitals) don’t think highly of UHC and think better of Kaiser" . But I could be wrong
Possibly so, and if so, I apologize to @Measure_for_Measure . However, I’ve seen “provider” being used in reference to UHC in these threads, and it’s not the correct terminology.
He is exactly what people were cheering for, an anti-evil-corporate-greed terrorist. What exactly turned him a kook? Genuinely curious.
I’ve no idea how providers rate Kaiser, and Kaiser is an odd bird to compare anyone else to, as they are vertically integrated, being all of the insurer, the hospital group, the primary and specialist provider group employer, so on.
UHC though is definitely not thought of as great by providers. See below as an example: