Wednesday, October 8, 2008

Health Insurance Flatline

I was wondering, with all the recent financial problems in the market and insurance companies failing, how soon will it be before health insurance companies begin to feel the heat? An old patient of mine said that "don't buy insurance, buy stock in insurance companies!" Insurance companies make their money off the interest they can get by investing in the market the money that they take in from premiums. When the market does bad, they do bad. How do they keep their bottom line? They stall on payments and pre-certifications.

I have asked our office if the have noted any changes. The big thing that they have seen is a new middle man. A firm that is contracted by the insurance providers to control pre-certifications. Working with them is next to impossible. In fact they even have hours that don't correspond to when doctor's offices are open just to decrease the number of cases that they have to approve. Every case seems to need a peer-to-peer review just to add to the burden of the whole process.

I can't help to think that perhaps the CEO's of the health insurance companies will have to take a pay cut this year. Then again, if it is only half, they will still get millions!

1 comment:

SeaSpray said...

Well first of all...I'm sorry that is happening to you and other physicians Throckmorton. It's just not right.

I left a comment over at the Independent Urologist's blog in which he discusses the processes involved in getting paid by the insurance companies for just your average office patient. I said I remembered a post of his where he stated he had to appeal twice for a claim the ins co approved prior to his doing the surgery. He was paid 6 mos later! That's just insane!

Can you stagger your office staff? They might not like the new hours... but it could help keep you from having to add an additional employee to your payroll. Then probably need your full staff during the day.

Or hire a part time employee willing to work the later hours but keep the hours low enough that you don't have to pay benefits. There are plenty of women willing and looking for light hours, have their husband's benefits that want to stay home with the kids... or whatever. I've done that and glad I could.

Or... pay someone to work at home if that is feasible.

I recently learned that at the hospital I worked at... the med floor unit secretary works 14 hour days. I didn't ask her but I am guessing 7am-9pm because I know how they cut our dept hours years ago and closed one office at 7, instead of 11 and put it on us in the ED. She stated she gets 3 days off a week. It has to be about saving hours and budget.

I would move mountains not to let the insurance companies get away with that. It's totally out of hand.

I was thinking of doing a post on Patient Rights as I was thinking of the elderly population in nursing homes and rehabs...and so was researching info on Google and stumbled on a Bi-partisan Patient Rights bill that was proposed by McCain, Edwards and Kennedy (McCain does reach across the aisle) but was voted down in 2001.

Anyway, there was something in the bill stating that insurance companies would be held accountable if any patients were harmed because of the insurance companies denial of authorizations thus preventing the patient from receiving appropriate treatment, tests, etc. That's not verbatim but the gist of it.

Too bad they can't be held accountable for WRONGFULLY delaying appropriate reimbursements to physicians!

And patients where applicable.