Thursday, October 23, 2008

Humana refuses to pay mental health costs, driving up mental health care, w/ telephone operators in India who ask for duplicate paperwork

I'm sorry. I just do not believe that the poor poor insurance companies are experiencing difficulties w/ not getting information.
I have yet to work out---for the THIRD TIME why Humana keeps asking me for a tax form and the last time I called some person in India associated w/ their provider relations wanted yet the same tax form again. I'll have to devote an hour or two to calling them, getting no one, or the information will not be there, or basically I will just sent the information out into the fax ethersphere and they'll call me again.

Humana is also the same Medicare Advantage company who will not pay for anything other than 90806 CPT code.

I hope that 'fair and balanced!' Humana will have some of its corporate welfare removed w/ the next prez gets in as re: welfare so that the poor poor insurance company could outbit Medicare.

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"Insurers question or reject claims "when we don't get full information or
when we get duplicate bills," said Karen Ignagni, president of America's Health
Insurance Plans" (see below, LA Times series on insurance problems: cut and paste:

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http://www.latimes.com/business/
la-fi-insure23-2008oct23,0,442561.story

From the Los Angeles Times
The battle of the medical bills
Doctors and insurers blame each other for an administrative headache that is driving up the nation's healthcare costs.

By Daniel J. Costello, Lisa Girion and Michael A. Hiltzik

October 23, 2008


"..."Insurers have found a very creative way of denying, delaying or slowing payments in a way that is having a real impact on patient care and some of our survival," said Von Crockett, Centinela's chief executive. "Every single doctor and hospital is writing off money they are legally owed but don't collect. It's an insane situation.....

Doctors and hospital executives say collecting payments from insurers has become an
expensive headache that is driving up the nation's healthcare costs.

Billing disputes and protracted payment delays are one consequence of a massive
consolidation among health insurers that has created de facto monopolies in much of the country, the Los Angeles Times found.

Two decades ago, the top 10 insurers covered about 27% of all insured Americans. Today,four companies -- WellPoint Inc., UnitedHealth Group, Aetna Inc. and Cigna Corp. -- cover more than 85 million people, almost half of all those with private insurance.

A 2007 survey by the American Medical Assn. found that in two-thirds of metropolitan
areas, one health insurer controlled at least 50% of the market. In the Los Angeles area, two companies dominate -- Kaiser Permanente and WellPoint's Anthem Blue Cross.

As a result, doctors and hospitals have little negotiating power and few options when an insurer rejects a bill. Some physicians are dropping out of insurance networks or turning away new patients. Others have moved to cash-only practices. Some smaller hospitals and solo-practice physicians say they are being driven out of business entirely.

The insurance industry lays much of the blame for billing problems on doctors and
hospitals. Insurers question or reject claims "when we don't get full information or
when we get duplicate bills," said Karen Ignagni, president of America's Health
Insurance Plans, the industry's lobbying arm in Washington. "Efficiency is a two-way
street....."

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