One of my buddies sent me this, an email referencing an article from the Washington Post - it’s content is quite good and pertains to some of the things that could happen as the UFT actively works against us (again).
Give it a read, and then listen to this poem ‘Hell is a Lonely Place’, by Charles Bukowski.
Denials of health-insurance claims are rising — and getting weirder, Elisabeth Rosenthal, The Washington Post
Millions of Americans in the past few years have run into this experience: filing a health-care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims — sometimes bundles at a time — without even reviewing the patient’s medical chart; a job title at one company was “denial nurse.”
It’s a handy way for insurers to keep revenue high — and just the sort of thing that provisions of the Affordable Care Act were meant to prevent. Because the law prohibited insurers from deploying a number of previously profit-protecting measures such as refusing to cover patients with preexisting conditions, the authors worried that insurers would compensate by increasing the number of denials.
A recent study by the Kaiser Family Foundation (KFF) of plans on the Affordable Care Act marketplace found that even when patients received care from in-network physicians — doctors and hospitals approved by these same insurers — the companies in 2021 nonetheless denied, on average, 17 percent of claims. One insurer denied 49 percent of claims in 2021; another’s turndowns hit an astonishing 80 percent in 2020. Despite the potentially dire impact that denials have on patients’ health or finances, data shows that people appeal only once in every 500 cases.
Sometimes, the insurers’ denials defy not just medical standards of care but also plain old human logic...
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Stories herein containing unnamed or invented characters are works of fiction. Names, characters, businesses, places, events and incidents are either the products of the author’s imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental.