America's disease of Insurancitis Indifferencious

Makes us accept the bloated paperwork process and casual denial management. We've gotten used to being told no.

In response to Moore's Sicko, Bryan of Why Now? discusses the single payer system and what it would do to the swamped 'system' we have going in this country:

Every medical procedure has a code, or multiple codes, and those codes are different for each insurance company. To get paid by the insurer the health professional has to file a claim using the forms and codes of that particular insurance company. If a patient is on Medicare and has “gap” insurance, two forms will have to be filled out using two different sets of codes.

There is an entire industry, medical billing, that has sprung up to take care of this paperwork, and specialized software [the reason I was involved] to allow a clerk to enter the patient information and have the proper forms produced. If you don’t use the software, you need a supply of forms for each insurance company, and a listing of each company’s codes.

Some companies group procedures under a single code, while others require you to enter multiple codes to describe the same actions. The software knows this, and takes care of it. A billing clerk would have to read the procedures for each of the companies to figure out what that company wants.

Single payer, means a single form, with a single set of codes. It might make it possible for doctors to once again have the old style office with a nurse/receptionist. These days, doctors are forming group practices to share the cost of billing, and the billing may come from a company in an different state.

Paperwork is a major cost of the American health care system that would be radically cut by a single payer system, and would have no impact at all on the quality of care. This is something that the insurance companies could have done decades ago, but chose not to, and just made it worse. Confusing billing procedures delays payouts, and that is one of the reasons they do it, no matter what they tell you.

Hipparchia in Bryan's comments suggests googling 'denial management'.

This explains the awful health care experience we had when my MIL broke her arm. All we saw was paperwork and insurance forms and kickbacks between suppliers and doctors....

Update: Go check out mapaghimagsik's latest: