Hello Pol,
My name is Steve. I personally work within the health insurance industry. I actually browse Sup Forums pretty regularly but I know you guys have been pretty antsy with questions and never had them answered so I am posting to try to help.
pic unrelated, somewhat, am from Texas.
I'm pretty good with health insurance, general insurance, auto accidents, municipal damages and other bullshit.
Just posting old photos I saved.
C'mon you faglords, this board cannot be this active regarding these topics and then never fucking want answers.
God damned. Slid to page 6 fast.
Did you ever witness someone being denied a rightful claim, steve?
Is it true that this is standard practise in that industry?
Fucking Sup Forums of all goddamn places has 20 slide threads about every goddamn topic.
Well yeah it's been that way since the election and continuously getting worse. Intensifies during happenings too.
Very rarely. The industry I work is legally required to give the benefit of the doubt. I've encountered people with what I have suspected as a year old injury but we cover it pretty regularly.
The cases are people claiming mental damage and (((anxiety)))
Yeah I figured that would be hard to prove. What about transgenders? Do you get requests for sex change OP's? Do you cover them?
Yeah, that's no joke. I legitimately made a thread after years of lurking just to answer questions about this industry. Gaht damn.
A family member of mine started receiving non stop scam calls right after being diagnosed with Dementia. I believe that someone who works in the hospital or with insurance may have sold his information to scammers.
bump for interesting thread
Interesting enough, we do rarely get transgendered requests. However, it's a bit of a process how they are taken care of. In literally all states you can get medical surgery if it's life threatening.
Sex change is an elective surgery, even if they completely feel they feel to be in that gender, it's hard to support their case. With enough money you can get anything done in the states.
Sex change requests, specifically, are really rare and the patients are required to undergo psychiatric evaluation, in my companies case.
Are there a lot of Jews in the high levels of the industry?
You could always go to a slower board like /biz/ and then screenshot/link to it. I made a thread about PSYOPS on /his/ and it went pretty well cause the shills and shitposters don't really care about smaller boards.
Do you think de-privatization of medical care/insurance would help cut down on the costs?
That is definitely possible. There are a ton of wrongdoers in this industry despite the fact there will be a paper trail. Literally that hospitals office will be able to tell who sent that letter and if they say that's wrong they are lying.
That being said, I use a non-descript cellular phone company and I get a ton of spam calls and even more recently so it could be related to that as well.
Also, if you can prove the info was sold you have a huge case, and I normally do not refer to lawyers because most are scummy.
interesting, thanks.
I have a few more questions about the prescription of opiates/opioids/benzodiazepines:
Do you feel like they're being prescribed often/for minor illnesses? For how long are they prescribed on average? Do pharma companies try to influence insurances so they prescribe their products? Do you review cases when there is a suspicion of abuse?
They started coming in on the same day of diagnosis. Usually about 20 calls a day. Blocking the numbers is ineffective and they will still come in even if the cell phone carrier and name on plan is changed.
Surprisingly no, most people I work with are conservative Catholics or black and general Christian, seriously.
I've learned to stay away from /biz/ as it's just shilling for coins since its inception.
This is a tricky one but factually I do not believe that. Government ran healthcare ultimately leads to controlled expenses, controlled wages, etc. which causes more stress on the system. Many doctors offices make a lot less than you would think.
I'll be honest and state I've never heard of ANY carrier or debt collector have such good technology regarding that. I don't know much else to say except that you can pursue state legal action if needed. I can help if you tell me which state you are in.
checked
Thanks for the advice
I’m working on a platform that help groups of people create their own mutual aid societies with a focus on healthcare, but it’s also applicable for other stuff. Do you think it pose enough threat to insurance companies that they’d try to kill it, like taxi unions have been trying with uber?
Hey there Germanbro,
Okay, so as for opiates and their ilk, they are hard as fuck to prescribe despite what you may hear. In the U.S. Opiates go through a process and their approval is touched by about 3 different people before the person ever actually gets their hands on them.
In addition, Opiates are hard as FUCK to prescribe. Emergency rooms in the U.S. can maybe prescribe a weeks worth of low dose opiates, Hydrocodones 5-325, at the most. Mostly Tramadol. The problem definitely lies in doctors who are pain management specialized who make nice deals and over prescribe, which takes forever to fucking catch.
Also, pharmaceutical companies are not as aids as Sup Forums would make you think. We rarely have issues with them, but we do find out.
Depending on illness, opiates can be prescribed for a week to years, and people at that level do get addicted, my company actually tries to help get them off.
God fucking no. You may think it's a good idea, but wait until the legal system kicks in.
You want to know why American healthcare can be so fucked up? There's legitimately millions of reasons. One wrong move at whatever facility you may try to create and you are jailed for live and/or fined over 500K. You're done.
I literally put a few doctors in jail last month for similarly stupid shit.
I will bump my own thread because Sup Forums constantly gets caught in habbenings cX
God damned
Even if it isn’t marketed as a healthcare tool but rather a platform to manage collective funds? What is being done to actual mutual aid societies that currently exist? I know they’re dwindling. Also, how’s the feeling in the industry for subscription based healthcare models which people pay a specialist or a group of physicians and get access to healthcare without the insurance as a middleman?
Im not fucking letting this slide to a bunch of other bullshit.
Hello Steve. How long have you been in the industry? I used to be in health insurance industry before obamacare and thought it was unfair for carriers to not cover some little kids asthma medication, but the premiums were half or a third of what they are today that the parents could pay out of pocket for a $4 inhaler. After obamacare and watching my premiums double and deductible triple I would much rather go back to before when illnesses were ridered out and people weren't penalized for opting out of coverage, what are you thoughts on where we need to go after obamacare?
Honestly, I do not know about mutual aid societies, it seems to be some form of social healthcare which honestly never works as higher specializations demand higher pay.
As for paying a physician/specialist directly, that sounds fucking awesome. However, what happens when that guy/gal breaks a law, cannot treat, makes a mistake, etc. It sucks ass.
Insurance carriers have a bit of scum attached to them yes, but we are a necessary evil to stop every which person from murdering and suing everyone.
>tfw another insurance bro
I work for a multinational as an inhouse investment advisor, my job is soul destroying and I only do it as I have found nothing else I am good at, hows insurance working for you?
Regulations cause the increase of all medical expenses. It's the 1 bad apple effect that causes compounding laws to ruin it for everyone.
I've also never seen a childs asthma medicine declined, it's generally so cheap that insurance companies who'd be willing to deny it are low tier and willing to take on bad faith.
In regards to obamacare and premiums, again the sad fact is that laws regarding the handling of medically sensitive information increase costs more than anything. A lot of them are good, but the system has become ridiculously bloated. I'd like you to go back to cheaper premiums myself, and if handling laws of medical information were lessened it'd work out.
REEEEE
Insurance is okay. I have found a company that is not soul crushing and honestly tries to do the right thing.
I am on a first name basis with my boss and my CEO, they make an effort and that makes it special.
>uber
>an unprofitable gypsy cab service that exploits temporary holes in the regulation of city taxi services and uses investor capital to maintain low pricing.
It's not the taxi (unions) that are trying to kill uber; it's the cities that have to deal with the fucked up traffic issues it creates. When regulation catches up the business will fold after the ((principle holders)) have dumped their stock.
keep buying tech stocks goys
Nigga what the beans?
I don't know much about this industry. Not enough to comment on it at least.
We are a insurance brokerage/consultancy and I work in a small forgotten office in the UK that supports the larger investment side of the business. Highest person I have met is VP of Health UK and he was basically just a stereotype of your out of touch, synergy loving, middle management arse. I go to work, barely get to talk to anyone and leave, half of what I do seems to have no real purpose. The up side is my salary and bonus are pretty good and I only work 35hrs a week.
I was on pain medication for several years. I was involved in a workplace accident that really messed up my back. I was sent to a spine care/pain management clinic by my GP because he wasn't comfortable prescribing me a lot of opioid pain medication. The spine care clinic did MRIs. CAT scans and X-Rays. They determined that I was not faking a condition. They determined that I would probably need surgery to have a chance of fixing my back and alleviating the constant pain. I have heard thousands of stories where back surgery has only exacerbated spinal problems and wanted to explore other options before consenting to surgery. Spinal steroid injections and other procedures were started. I was prescribed muscle relaxers and painkillers, initially hydrocodone 5-325 and after a year with no positive change was moved up to hydrocodone 10-325. This continued for another year, the Dr then advised upping my pain meds to Oxycodone 10-500 (Percocet). I agreed as the hydrocodone were no longer effective in controlling my pain. I continued on the Percocet 10s for another ~4 years this time frame was interspersed with various non-surgical treatments that were ineffective. I went in for my monthly appointment and the Dr stated that unless I was ready to try surgery he would no longer see me. At this time I was the sole provider for my family, I had short-term disability insurance through my employer, it only pays 60% of what I would have earned on straight time, I NEVER worked anything less than 60-80 hours a week. What the short term would pay wouldn't be enough to maintain my bills and housing and family. I tried to apply for some government aide, really felt like a nigger trying to get the additional help that would be needed. Unfortunately, even at 60%, the short-term disability insurance would be paying me too much to get any assistance... I explained this to my Dr. he immediately stopped my pain medication and refused to see me any longer.
Why is there a coverup involving fluoride's direct antagonistic effect on melatonin?
After 4-6 years of opioid pain medicine 4 times a day I was forced to quit cold turkey. It really had not occurred to me that I was addicted and dependent on opioid medicines, basically a socially accepted form of heroin. I turned to buying pain meds from coworkers, people that they introduced me to etc. I became a fucking addict. I found another Dr. that was very lax about prescribing pain meds, I started seeing him and continued to buy pills off the street as they were available because I didn't want to find myself in the same situation as I did after the first Dr. quit seeing me. I justified continuing using the meds as my back was still messed up, it was hard to work without them due to the back pain, My kids were young at the time and I felt like a crappy daddy if I couldn't play with my children due to my blown out back and the immense pain that I lived with, I felt like a crappy dad when I was out buying pills from freaking drug dealers as well. Eventually, I found Kratom and weaned myself off of the opioids with it and then a few months later I weaned myself from the Kratom and now I just live in constant pain and cope as best I can.
This is very common. Can you please describe what the doctor/ worker's compensation described as your injury.
I honestly run into 100s of back injuries yearly. Lots of the time people are obese, have minor-moderate degenerative disc disease, etc. going on.
So, what I am saying is did your doctor state you had a protruding disc, possibly nerve encroaching? Anything?
Also, short term disability sucks, but it's easier to get long term disability than from transitioning directly from worker's compensation. Also, most states have a maximum benefit rate. Texas has been $895 and $913. Most people who earn more are in supervisor roles who don't need the services as much.
That beer was my favorite beach beer but disappeared this past summer in the East Coast. Did they discontinue it?
Also work in insurance, pretty fucking awesome job.
Honestly sir, you are legitimately not alone. I personally have a lot of chronic pain and sadly a lot of the time all we can say is that we give you permission to hurt.
You can have hundreds, thousands, of back diagnostics. Depending on your personal condition I cannot tell you what is best.
Based on your current description, I would say you have degenerative disc disease, are likely overweight, and you definitely work in a blue collar industry. I expect you work in machine repair?
I promise, I'm not trying to trivialize you if I am wrong, I literally am here to help.
It was last years summer beer released in 6 packs, and 2 years ago it was their summer seasonal (1 per 6 pack of family beers). It is fucking top tier.
What branch of insurance do you work?
S1-S4 I had developed scar tissue that was scraping and pinching nerves, herniated discs, 2 discs completely blown out that he wanted to replace with super new titanium discs etc. I could dig into my files and upload the pics from the MRIs but it's really not worth doing so right now.
About me: I am 6'2" ~250 lbs. Mostly solid, I worked as an industrial maintenance mechanic for ~10 years and enjoyed the hard work and heavy lifting etc as it was great exercise.
bump
Ah, well hope it comes back. Fantastic stuff.
Health insurance, I work in reporting. Get to work with a lot of industry-standard tools that are going to rocket my career when I leave in a few years. Like what you said the people at my company really care about the community and work hard to keep costs low and health high. Pretty proud to be a part of it.
It sounds like you have a severely fucked up back. You seem to have severe disc disease and herniation. Your doctor seems to have wanted to do a fusion, I've never heard of titanium discs to be honest.
Sadly, you will have been considered a work risk injury. I do not know what state you are in, but there are a few you could possibly appeal and be granted worker's compensation, if you are within the legal time limit.
The saddest part of your story is that basically everybody in the US knows somebody that went through the exact same bullshit. How the fuck is there not more outrage about this, considering how common and widespread it is?
I live in GA and the time limit has run out. I had thought about bringing a lawsuit but as it was an accident it didn't seem morally right try and sue the company. As they say, it is what it is. I have a fairly normal semblance of life most days now, I have lost weight and taking better care of myself.
My health insurer has me pay a $70 co-pay to visit the doctor. X-ray's, blood tests and whatnot are an additional $70 each. After I go, they send me $40 to offset the cost I've paid. Where that's fine and dandy this has stopped me from going to the doctor or at least has stopped me from ever getting any further evaluation done when I've thought I've had a problem.
My questions is: I haven't been to the doctor since July, but these past months I've been receiving several checks up to the amount of about $160 though I haven't been. I'm not complaining, but what's going on?
Know anything about life insurance?
What outrage? He literally described a standard high grade injury. There is about 5 fucking options to take. Most of them don't help long standing.
What are questions you’ve seen people ask that you could answer? Or what are some misconceptions people have?
I used to be a fitness person to, the best you can do in all seriousness is exercise your lower back and do regular stretches. It will give you some pretty severe relief.
I'm not positive in your case since I don't know your policy. What is possible is that you have a flat cost, but after so many visits it increases to some amount. Do you have something you are looking for for further testing?
I really don't know much about life insurance, honestly, the personalfinance reddit is really good at that.
It is pretty fucked up and as you said nearly everyone knows of at least one or more people who have wound up in this situation. The thing that really spurred me to get off of the pain meds was the night I and buddy went to see a guy to buy some pills from. We get there and the guys say's he has bad news and good news. Bad news is he's out of pills, the good news was that he had some heroin and he was selling it cheaper than the pills we were going to buy. "Nah bruh, I'm good!"
Still can't get over that line, The GOOD news is he has heroin... WOW, The things that happen to you in life that you never think would be even remotely possible. BAKA
People think insurance is fucking evil and that's ridiculous. The sad fact is it has been abused by and large over a period of time. Most insurance companies legit operate at a loss and profit in other ways.
Most people who complain have never spent multiple days or had multiple specialized treatments, and only walked away with $1000-$2000 in bills.
Also, most states have a state ran health care. Texas has multiple places you can get free treatment per the tax payers.
Those were some pretty big predators and I'm sorry you went through that. I've personally dealt with people on all sides of that issue.
Well I like you guys, but I guess there's no more.
Outrage that health care professionals have been getting huge portions of the population hooked on hard core drugs, with what seems to be a callous disregard for their well being. Tons of middle aged people that believed if their doctor prescribed them something it's in their best interest to take it. These people don't know shit about drugs because they don't do them, and they get lead straight into hard core drug addiction and catch themselves blindsided by it because their doctors lead them there.
You obviously don't know shit about the healthcare industry and should stop posting. You have no idea how hard it is to actually prescribe medication.
>You want to know why American healthcare can be so fucked up? There's legitimately millions of reasons. One wrong move at whatever facility you may try to create and you are jailed for live and/or fined over 500K. You're done.
Get the government out of healthcare, and things are much, much different.
[And ideally getting them out of insurance and financials, too.]
Too dumb to ask anything, smart enough to bump
I have a legitimate question. Would single payer healthcare on a limited basis really be that bad? Single payer for basic medical care and the option to purchase supplemental insurance for a more tailored approach to coverage (more like P & C insurance)? Seems like this was Trump's original plan, and now it has gone by the wayside. As much as everyone fears state run health care, it seems like covering just the basics through single payer would alleviate much of these concerns.
What do I do? I've changed States and no longer covered under Obama care. There's no %$#@ing way my wife and I can afford $700/Mo with medications on top of that.
Hell, we couldn't afford $700/Mo now even. That's a month worth of rent.