Insurance companies are not our friends. These companies will do everything they can to get out of paying for the thing they are supposed to pay for. Stories of people getting one over on these corporations are incredibly satisfying.
Insurance companies are not your friends and will do everything they can to save money, including not paying for your medically necessary services. There's a lot of news coming out about insurance companies using algorithms to deny claims and doctors signing off on them.
Before algorithms, they would have minimum wage employees reading over these claims for the doctors instead. That's what I was. I was 19 years old, working for an insurance company denying claims. I would be the first line for doctors to call and explain why they thought they needed a service or medicine.
For some reason, 19-year-old me, with no medical experience, was allowed to tell these doctors that services were not needed medically. This job was the easiest yet most miserable job experience I ever had. I was only able to last a few months there.
During my last two weeks, I was slacking off. I was just so burned out. I couldn't stand denying, yet ANOTHER case where someone needed meds, and the insurance company didn't want to pay for them. I was reprimanded for not working hard enough and getting processed.
Insert malicious compliance. I worked faster than I ever had before. That's because I approved every case that came before. Every doctor I spoke to, I just gave them approval. Every prior authorization I saw was approved.
I did this once during my first week and was told not to do it again because I had to follow company guidelines, but I didn't care. I probably was able to approve 50+ cases before I quit. I hope it made it different for those people. F*ck health insurance companies.
Heroes come in all sizes.
Where were you this past week? I saw my GP on Friday afternoon and had two prescriptions called into the pharmacy. I received a message that they were ready for pickup around 5 PM. I arrived at the pharmacy before six, and the insurance company denied one of the meds.
I called the insurance company and talked to a person (he may have been on the West Coast and was still at work). He indicated that the doctor needed to approve the medication. I asked isn't that what the prescription is? He said that the insurance company needed further approval. I still don't understand what more they need.
I worked in a pharmacy for over a year, and the pharmacist I worked with was one of the best in the county (possibly the state). One day she was talking to a customer, and I overheard her say, 'I've been working here for 14 years, and I still don't understand insurance.'
No offense, but it makes sense that those prior authorizations could have been based on someone still young enough to be in high school just going, 'Yeah, sure' or 'Nah, not good enough.' F*ck insurance companies cause at least 80% of our issues, most likely closer to 90%.
When I was a working physician, the worst part of my life was dealing with insurance stuff. Now that I'm disabled and can't work, the worst part of my life is dealing with insurance stuff