Sometimes I am ashamed to work for the Healthcare industry...

JTNismo

JTNismo

Spectator
I work for a big health insurance company which I rather not disclose. This morning I received a call from a brain surgery group who stated they have a patient at the ER waiting for an emergency brain surgery but they will hold off until we agree to pay them a higher claim's reimbursement than the one already under contract for such procedure. They demanded this as they were the only brain surgery group on call at the moment that was able to carry on with this surgery. Do you people see what they are trying to bank on? Of course the contract rules but it doesn't keep them from trying and in the mean time, the patient could die, for all they care, waiting for this stupid bureaucracy BS to go thru. Reminds me of "John Q". Due to my employer's private information policies, I can not disclose the names of the establishments involved but I wish I could. People should know of the places they shouldn't seek services from. This sucks!!! I will be getting out of healthcare soon. :mad:
 
yeah i heard about that stories i think is really fucked up from the doctors and the health care companies... doctors took a vouch to save people..but they just want more money.. is sad..and insurance companies they see all with $_$ eyes...
 
neighborhood health? i wouldnt want some big burly guy named bubba to perform brain surgery on me.

"ima pull dat lump out cho nose"
 
wow!!! damn bro thats realy fuked up, thanks for sharing that story, its hard to work in those kind of conditions.
 
this is why i go to the cuabn guy in the van, in Hialeah to get my health care. no but this is bullshit and we live in the "freeest" country in the world and we have hear about cases like this. as fucked up as Cuba is there health care is on of the best in the world i know of many people from Europe that go to Cuba to get fixed up.
 
bishoptaner said:
this is why i go to the cuabn guy in the van, in Hialeah to get my health care. no but this is bullshit and we live in the "freeest" country in the world and we have hear about cases like this. as fucked up as Cuba is there health care is on of the best in the world i know of many people from Europe that go to Cuba to get fixed up.
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You're on crack roberto. Health care in Cuba is a terrible thing. Go to youtube and watch some hidden camera vids of non-tourist hospitals in Cuba. Its nothing to brag about.
 
By the way it only got worst. This doctor really took it to the next level. I just learned the doctor refused any offers we made. Despite the urgency of the situation, he refused to provide services and now the lady has to be transfered to a different facility that will accept our reimbursement rates further prolonging her unfortunate situation. I feel both my employer and the doctor played with that person's life. All about the money and the hell with the humanistic part of all this. It could be anybody's family memember in here you know.
 
Let me guess United Health Care which is the parent company for Neighborhood Health. Neighborhood Health was created by United Health Care to provide Health Insurance for a much cheaper price, but what they don't tell you is that you are coverage is a lot less, than if you were to have United Health Care as your insurance provider, but you are still screwed with a $300 monthly for their insurance premium. Hopefully everything turns out ok for this patient, but it's ridiculous the amount of control these Dr.'s have.
 
DUDOCIUS said:
Let me guess United Health Care which is the parent company for Neighborhood Health. Neighborhood Health was created by United Health Care to provide Health Insurance for a much cheaper price, but what they don't tell you is that you are coverage is a lot less, than if you were to have United Health Care as your insurance provider, but you are still screwed with a $300 monthly for their insurance premium. Hopefully everything turns out ok for this patient, but it's ridiculous the amount of control these Dr.'s have.
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i have united man and its coverd me pretty well...i barely pay for stuff....but i pay like 90 bucks a month.
 
DUDOCIUS said:
Let me guess United Health Care which is the parent company for Neighborhood Health. Neighborhood Health was created by United Health Care to provide Health Insurance for a much cheaper price, but what they don't tell you is that you are coverage is a lot less, than if you were to have United Health Care as your insurance provider, but you are still screwed with a $300 monthly for their insurance premium. Hopefully everything turns out ok for this patient, but it's ridiculous the amount of control these Dr.'s have.
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LOL :bigthumbu @ your guess
 
I had United Healthcare when I was under my Mother's medical insurance, once I wasn't a full time student, I got the boot.
My current job offered me Neighberhood Health, and I took it.
It's hard for me to get medical insurance on my own, because of my pre existing condition.
 
JeepsteR118 said:
i have united man and its coverd me pretty well...i barely pay for stuff....but i pay like 90 bucks a month.
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United Health Care is great as is every Insurance company, up until you need to have something major done (ex. Brain Surgery). Then they want to question how much money each procedure should cost, which causes the back and forth debate with the Dr.'s while your are dying in your room waiting for these jerks to decide whether or not your life is really important.

You pay $90, but I'm sure the company that you work for is a couple of hundreds on top of your $90.
 
D. Davaine said:
this is why i go to the cuabn guy in the van, in Hialeah to get my health care. no but this is bullshit and we live in the "freeest" country in the world and we have hear about cases like this. as fucked up as Cuba is there health care is on of the best in the world i know of many people from Europe that go to Cuba to get fixed up.
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Freedom not free shit.
 
United Health did not create NHP. NHP was a separate entity and UHC bought them off a couple years ago. The perspective of weather UHC or any other insurance is good or not depends on way too many factors specially on the employer if you are a recipient of insurance benefits through your employer (ex. those people whose employers take most of the tab may perceive UHC as a good insurance). Or on how much you pay if you take full tab. The more you pay monthly the less out-of-pocket you pay when you need to use your insurance and also the wider that your provider network becomes. I had UHC through another employer before and I had better insurance benefits (deductibles, copays, etc) than now that I work for them. Ironic isn't it? It usually comes down to the network of providers. Cosidering exceptions, for the most part, the bigger insurance companies provide a wider net of providers so you have more choices when it comes to second opinions and $#!tt like that.

As far as the lady who needs surgery, that's just wrong as fuck. Both Insurance and doctors are just green beatches equally, in my eyes. I am starting a new job next week therefore I will confirm the Surgery Group's name as well as the insurance provider then, so that people know more less what to expect from them, if God Forbid people end up pursuing services from any of these entities.
 
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yesterday was a hearing for a class action suit against my old heath provider from when they tried stealing a out of court settlement from my accident! needless to say from me going after them with my lawyer they are giving back over a million dollars to others envolved in the same suit i was head of!

your story is sad....i know first had how the health care providers work...sent me to a nursing home for 5 weeks before a major surgery on my back just so they didnt have to pay the hospital for my stay. i was 25 at the time and sharing a room with a stroke victim.
 
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