State To Release HMO's Documents On Claims
courant.com | State To Release HMO's Documents On Claims
THe long and the short- If you make up your own criteria for what is medically necessary, and then deny people based on your narrow viewpoint, then you make money.
Toubman, who represents indigent clients as a member of the New Haven Legal Assistance Association, fears the HMOs have created their own definitions of what services are "medically necessary" or "medically appropriate" and are rejecting legitimate claims.
Since the Workers Insurance dudes do the same thing, it will be interesting to see what happens if the Insurance Co is found guilty. What will be the implications for other insurers???
Hehehe... I like this dude.
THe long and the short- If you make up your own criteria for what is medically necessary, and then deny people based on your narrow viewpoint, then you make money.
Toubman, who represents indigent clients as a member of the New Haven Legal Assistance Association, fears the HMOs have created their own definitions of what services are "medically necessary" or "medically appropriate" and are rejecting legitimate claims.
Since the Workers Insurance dudes do the same thing, it will be interesting to see what happens if the Insurance Co is found guilty. What will be the implications for other insurers???
Hehehe... I like this dude.
posted by Impatient Patient at Wednesday, March 28, 2007
1 Comments:
Hi Impatient Patient, thanks for your link from Dr Crippen,s comments. I'm tired (it's getting on for 9pm over here and I had a bad night last night) but will look at your posts better tomorrow with a bit of luck...
Best wishes from Liverpool
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