Tuesday, January 30, 2018

Insurance Denied A $12,000 ER Visit Because The Appendix Was Not Ruptured

Insurance Denied A $12,000 ER Visit Because The Appendix Was Not Ruptured
This is a deeper problem with health care in America than it might appear. 
It costs $12,000 to rule out appendicitis while it could be ruled out by a simple good history, a good physical exam, and maybe a $40 test if even needed. Everyone wants to go to the ER and get a CT scan because everyone is becoming his own doctor and believes he is a graduate of Google Medical School and knows better than all doctors! 
The patients do not go to their doctor because he can't see them soon enough because he has no time because he or she is seeing 30 patients a day because insurances do not pay enough and demand more to save money. Insurance companies are not so smart because the patients end up going to the ER and it costs them $12,000 for an average visit instead of a 50 or $100 for the PCP. To make up for the added expense, insurance companies rais, the premiums for everyone and reduces coverage and doctors' pay and the cycle goes on until one day it will crash.

ER visits cost a fortune because no doctor has the balls to think and take responsibility for his own clinical judgment without the proof of a $10,000 test or an MRI because he or she is terrified of being sued. Our sue happy society screws physicians and sue for no good reasons, so physicians practice a brainless very defensive expensive medicine with unnecessary testing for everything which sky high the cost and screws up the insurance companies. Since insurance companies do not lose, they increase the rates, deny hospital payments, reduce the coverage and reduce the doctors' pay to keep their profit high. Basically, they screw everyone in the end.

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