Administrator rev ronin Posted December 18, 2014 Administrator Share Posted December 18, 2014 No, you don't wish everyone had *insurance*, you wish everyone had *healthcare*. Falsely equating the two is part of the problem. Think different! Link to comment Share on other sites More sharing options...
jmj11 Posted December 18, 2014 Author Share Posted December 18, 2014 So, here is something that I don't understand. I think it is part of the ACA that private insurance companies MUST spend 80% of their collections directly on patient care, leaving 20% for over-head / profit / stockholders. So if the insurance companies are charging more and more and covering less and less, where is that money going? Is it going for high cost (almost end-of-life) care (speaking of multi-million dollar treatments for some types of cancer) or, are they hiding the money somehow through smoke and mirrors? I honestly don't know. Link to comment Share on other sites More sharing options...
bobuddy Posted December 18, 2014 Share Posted December 18, 2014 Turns out - my metformin prescription that was denied - they would only cover the immediate release. The metformin ER that I wanted the patient to be on is on the Kroger $4 list. I told the patient to just pay cash for it. Just. plain. nuts. Link to comment Share on other sites More sharing options...
cbrsmurf Posted December 18, 2014 Share Posted December 18, 2014 next step will be to fill out a prior auth to examine the heart and other systems please fill out a prior auth to examine the lungs 1) did you check to see if the patient was still breathing? 2) if so, when was the first time you noticed the patient breathing? 3) have you tried letting the patient breathe for 1 hour? Link to comment Share on other sites More sharing options...
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