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Plain and simple regulation - Coverage cannot be defined by insurance. It has to be defined by providers. But what about fraud? Well, maybe don't start a healt
by nine_zeros 4y ago
Plain and simple regulation - Coverage cannot be defined by insurance. It has to be defined by providers.
But what about fraud? Well, maybe don't start a health insurance company if you can't deal with it.
- fallingknife 4y agoWhat do you mean don't start an insurance company if you can't deal with it? Your first sentence says they shouldn't be allowed to deal with it.
- ceejayoz 4y agoIf an insurer believes a provider is committing fraud, that should be between the two of them. The patient shouldn't have to be the negotiator in the middle; they have zero power over either side. Too many fraudulent/suspicious claims from a provider? Cut the provider off, not the patient.
- macinjosh 4y agoThey would deal with it by passing the cost of the fraud onto the patients paying principles. Now you have more problems. There is no such thing as a plain and simple regulation.
- HDThoreaun 4y agoThe issue with this is that there is absolutely gigantic amounts of over prescription of care in the US because of the payment structure. Many common procedures not only aren't helpful but are commonly actively harmful, but the surgeon who recommends it gets paid so they'll keep on signing people up.