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This simply incentivizes a rapidly revolving door between practice and insurance, with a likely effect of making the actual practioners as a populace more frien
by haneefmubarak 3y ago
This simply incentivizes a rapidly revolving door between practice and insurance, with a likely effect of making the actual practioners as a populace more friendly to the insurance companies in general (in expectation of quid pro quo).
- ceejayoz 3y agoThere's something deeply wrong when a gastroenterologist who hasn't seen a patient in person for decades can deny a neurosurgical procedure. Maybe you make it like jury duty; if you're a practicing doc, you periodically get randomly assigned some appeals in your speciality to review. The current system already has a massive quid-pro-quo; if you aren't willing to spend 1.2 seconds to deny tens of thousands of claims a month (not an exaggeration! https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims https://www.propublica.org/article/cigna-pxdx-medical-health...), they'll find someone else. The docs and companies doing these "independent" reviews are completely captured by the industry already.
- JumpCrisscross 3y ago> Maybe you make it like jury duty; if you're a practicing doc, you periodically get randomly assigned some appeals Or send appeals to a committee of randomly-rotating reviewers. The state could administer the service to promote fairness and lessen the cost to the insurer.