[HN Gopher] Insurance companies fill their networks with 'ghost'...
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Insurance companies fill their networks with 'ghost' therapists
Author : apwheele
Score : 40 points
Date : 2023-10-04 21:59 UTC (1 hours ago)
(HTM) web link (www.seattletimes.com)
(TXT) w3m dump (www.seattletimes.com)
| didgeoridoo wrote:
| My wife is a clinical psychologist who used to take insurance.
| She got tired of not being paid for months for patients she saw.
| Legally they have 90 days to pay you, but in practice it's closer
| to 4-5 months. Every January they claim to have "computer
| problems related to the new year" and simply lose huge numbers of
| claims, requiring you to resubmit -- oh that claim is more than
| 90 days old even though it was their system that "lost" it?
| Sorry, can't submit! Guess you just worked for free!
|
| She takes cash now. It was an abusive system and I'm not
| surprised it's falling apart.
| jwie wrote:
| It's unlikely this is as interesting as the headline suggests.
|
| Maintaining a list of professionals is challenging. There are
| very simple input problems with this kind of data.
|
| The professional, in this case a therapist, but it really doesn't
| matter what they do, just isn't going to keep their portal
| updated on the insurance network aggregator.
|
| The insurance companies can't make the anyone update their
| listing, and the professionals don't have incentives. They're
| full up on work so there's no real need for them to do anything
| to get clients.
|
| This is a bog-standard supply and demand problem.
| neonate wrote:
| http://web.archive.org/web/20231004220011/https://www.seattl...
|
| https://archive.ph/Nl7gj
| PaulHoule wrote:
| I wouldn't necessary blame the insurance. My primary care doc
| gave me 10 referrals to psychiatric nurse practitioners but zero
| were taking new patients. I asked someone who'd written review
| articles on my condition to do the same and he said he would but
| I think he did some looking and came up short and ghosted me.
| chimeracoder wrote:
| > I wouldn't necessary blame the insurance.
|
| Why not? They're the ones who are gatekeeping the product
| (their network) at the same time as they're selling access to
| their network (this is considered one of the "features" on
| which insurance companies compete and sell their product).
|
| Not to mention that, as mentioned in the article, insurers are
| _legally required_ to maintain a sufficiently large network to
| enable their patients to receive care in a timely manner.
|
| If insurance companies want to restrict patients and limit them
| to seeking care from providers within a preapproved,
| artificially limited network, then it's totally fair to
| criticize them for not ensuring that their network is
| sufficiently large and accessible to be practically usable by
| patients.
| toomuchtodo wrote:
| Insurance is collecting premiums for care that can't be
| provided. I blame them.
| notacoward wrote:
| Yes. All the time. First you have to find a therapist that
| actually exists. Then you need to find one who returns a simple
| email or phone call. Then one who is willing to take you on as
| a client, and finally one who actually has the tools to help.
| And each step is _hell_ for someone with any of several
| conditions that might have been why they were seeking a
| therapist in the first place. It 's no wonder we have a crisis
| - if that's even the word for something that has been going on
| so long.
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(page generated 2023-10-04 23:00 UTC)