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Yea there are cottage industries on top of cottage industries in the medical insurance space. First you have the first order: DR supplies service, bills patient

Yea there are cottage industries on top of cottage industries in the medical insurance space. First you have the first order: DR supplies service, bills patient’s insurance, then you have the hospitals who outsource all billing, those outsourced companies outsource the claims management, which outsource the claims response, and the exact same structure exists on the insurance company side. And I’ve simplified a lot… there are coder companies, insurance coder consultants, etc. it’s totally wild. If you ever wonder why. US medicine is so expensive: it’s bec there are 100 hands all reaching for their piece of your $120 annual checkup. Or put another way, HIPPA is nice and all, but by the time all is said and done, 8-10 pairs of strangers eyes have seen your vagina fungus infection pharmacy bill.

TheNewsIsHere 2y ago
I once was lucky enough to have my primary care physician through a university teaching hospital that outsourced almost nothing. Billing was in-house, insurance ops and claims processing was in-house. Labs went to an accredited in-house reference laboratory. I am sure it was easy to justify doing everything in-house because the university held accredited degree programs for virtually every healthcare area from medical school to ophthalmology and optometry, physical therapy, pathology, dentistry, a college of nursing, pharmacy school, as well as specialties like oncology, cardiology, and anesthesiology. For the areas that weren't medical disciplines, they operated degree programs for bioinformatics, hospitality (the hospital cafeteria was excellent), and several other areas that just so happened to address essentially all the needs of a modern healthcare organization. It was a fantastic model, but it might have only made sense in the context of a large teaching hospital.

TheNewsIsHere 2y ago

I once was lucky enough to have my primary care physician through a university teaching hospital that outsourced almost nothing. Billing was in-house, insurance ops and claims processing was in-house. Labs went to an accredited in-house reference laboratory. I am sure it was easy to justify doing everything in-house because the university held accredited degree programs for virtually every healthcare area from medical school to ophthalmology and optometry, physical therapy, pathology, dentistry, a college of nursing, pharmacy school, as well as specialties like oncology, cardiology, and anesthesiology. For the areas that weren't medical disciplines, they operated degree programs for bioinformatics, hospitality (the hospital cafeteria was excellent), and several other areas that just so happened to address essentially all the needs of a modern healthcare organization. It was a fantastic model, but it might have only made sense in the context of a large teaching hospital.