The Journal. Even Doctors Are Frustrated With Health Insurance
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Dec 19, 2024 A tragic event involving a health insurance executive has ignited public outrage, particularly among doctors. Healthcare professionals express their mounting frustrations over treatment denials and the headache of navigating insurance hurdles. The discussion reveals the emotional burden these challenges place on both doctors and patients. Personal anecdotes highlight how these issues impact medical practices, emphasizing a critical need for transparency and better practices in the insurance industry to protect patient care.
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Denied Kyphoplasty
- Dr. Nguyen, a spine specialist, shared how insurance companies frequently deny necessary procedures.
- One such procedure, kyphoplasty, helps patients with spinal fractures walk again with significant pain relief.
Impact of Denials
- Insurance denials discourage patients from seeking necessary treatments.
- Delays caused by pre-authorization can worsen patient conditions or lead to patients abandoning treatment altogether.
Peer-to-Peer Review Issues
- The peer-to-peer review process, intended to ensure appropriate care, is flawed.
- Doctors often find themselves justifying their treatment plans to reviewers outside their specialty, leading to inappropriate denials.