<p>Why should I have to argue with some probably underpaid (compared with the CEO) of an insurance company to justify life saving cancer treatment for a chid?
How broken is our system, with its insurance CEOs raking it in:
- Old days: kid needed chemo, kid admitted for chemo.
- New days: Pre-cert kid for chemo- paper must be filled out on our end (hospital), sent, looked at by someone on insurance end, approved (maybe), not approved (MD notified, has to call and argue with insurance company- eventually some stupid medical director who is making a cushier life than if he/she were actually doing medicine).
- New: hospital days denied in the middle of a 10 day admission (for example) because kid wasn’t getting therapy insurance company deemed inpatient. What the ?!@#% are we supposed to do? Discharge the kid in the middle of needed treatment? And readmit?
- New: hospital days denied by insurance company. Attending MD notified. Attending MD argues with insurance company dweebs. Good luck. Oh, and they continually are LATE wtih payments to hospital. Saves 'em money.
I live this every day- major children’s hospital. Provides much in the way of charity care.</p>
<p>And my personal favorite- kid needs to find an unrelated donor for a bone marrow transplant. (this costs money). Insurance will “cover” the transplant (10c on the dollar, maybe), but not the search. How, exactly are we supposed to proceed to a transplant if we don’t have a donor??</p>