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“Medicare was the most likely to deny any part of a claim, with a 6.9 percent rate. Aetna was a close second at 6.8 percent while the others ranged from 2.7 percent to 4.6 percent."
You also have to look at how many people Medicare serves and how many people the private insurers serve.
From the look of it, Medicare isn't doing all that shabby.
You do have a lot of seniors who go to the doctor because they're lonely or for some it's a social thing.
You also have to look at how many people Medicare serves and how many people the private insurers serve.
From the look of it, Medicare isn't doing all that shabby.
You do have a lot of seniors who go to the doctor because they're lonely or for some it's a social thing.
That's why we have percentages to look at. Medicare leads the pack in claims denied.
You also have to look at how many people Medicare serves and how many people the private insurers serve.
From the look of it, Medicare isn't doing all that shabby.
You do have a lot of seniors who go to the doctor because they're lonely or for some it's a social thing.
I don't care why seniors go to the doctor (but the idea that "a lot" go because they're lonely is patent nonsense) the fact remains that it is doctors, not the patients, who prescribe care and it is that care recommended by a medical professional that is being denied. Obama is proposing 500 billion dollars in Medicare cuts. So be prepared to see the percentage of denials rise dramatically.
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Quote:
Originally Posted by sanrene
That's why we have percentages to look at. Medicare leads the pack in claims denied.
We have nothing here, in these charts a $1.98 line denied carries the same weight as a $ 5,000.00 line denied.
BTW, it's claim lines (parts of a claim) denied, NOT claims denied. There's a vast difference in sample sizes here which also takes away from any significant meaning.
You do have a lot of seniors who go to the doctor because they're lonely or for some it's a social thing.
You hit the nail on the head with "some" seniors. I don't doubt that weekly appointments are a series of showing up for one's appointment (have someone drive you if you can't drive yourself any longer and take a few hours of their productivity away), waiting in the doctor's office for 1/2 an hour, having the nurse open up the door and say, "Good morning/afternoon, Mr./Mrs. Jones/Honey, how are you today." Listen to a list of aches, pains, and ailments, take weight and blood pressure. Have the doctor come in for a few minutes, take a look at the chart, and schedule an appointment for next week. Diagnosis: You're old. Nothing's changed since last week except you're a week older. We will all be there. It doesn't mean that I have to be the bottleneck in the healthcare system and deny people who truly NEED to see a doctor from getting their care because I hog up all the money via Medicare. This upsets me royally. Not politically correct to say this? It's how I feel.
P.S. - to the person that said that Medicare leads the pack with claims denied, I find that hard to believe unless there are tons of people taking advantage of the system (this includes patients, doctors, hospitals, etc.). My MIL went to the doctor constantly, had all kinds of procedures done (all paid for by Medicare), had a pace-maker installed at $12,000 a crack. Died a few weeks later because she had umpteenth OTHER things wrong with her because her body was here on this earth a long time. Everything breaks down after how many years, including us. In the meantime, private insurance "death panels" deny life-saving treatment for the working man and woman in this country. Sorry, something is amiss.
I would hate to see the push for universal health care access, which I support, turn into into an "age war".
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