Pips

At this point, r/worldnews comments are so thoroughly astroturfed by so many global powers, their only use is to get an idea of what various propaganda machines think.

So Israel planted explosives in known communication devices, that could easily be tracked or also had pinpoint tracking technology included with the explosive, then deliberately waited until the intended targets could cause collateral damage to unarmed civilians to set them off? And you argue this is different from terrorism in what way?

It's low collateral damage the same way a suicide bomber is. So, I guess, your IDF-brained take is suicide bombers are low casualty and precise.

"Use a Tardiss, Ivanova!" Sisko declared calmly.

Then fair enough, I apologize for assuming she works in private insurance. Your initial framing and argument made it seem otherwise. I still think you and I disagree on the need for widespread chart reviews for medical necessity.

When you said doctors are not infallible, you said it in response to my claim that, in essence, the treating doctor should always get deference. It is natural to assume that you did not believe the same standard applied to reviewing doctors at Medicare since you've been arguing the same.

As you note, treating doctors frequently appeal Medicare denials. That's a lot of wasted time and money. I see no evidence that these denials are saving more money than is being wasted fighting them. I'm having trouble finding data for traditional Medicare, but for Medicare Advantage, appeals routinely get overturned to such a degree that Congress investigated it.

You stated earlier that doctors are required to take notes and your wife relies on these notes when making a recommendation. Doctors are notoriously bad at documentation. It's why relying on their notes to make a judgment as to medical necessity is a terrible idea. I firmly believe no one should be denied coverage because their doctor sucks at writing a report.

Medicare or Medicare Advantage? Because Advantage is private. Medicare has like 5 levels of appeal, including to a federal court, most of which is free. There are systems in place to allow challenges to the reviewing doctor's denial. Private insurance typically forces arbitration.

I have problems with Medicare's system too, especially when it comes to claims denials. If it is a covered item or procedure, the claim is not fraudulent, and the insurance provider has not met the patient to perform any exam, then going off of notes and comparing with best practices is insufficient to deny a claim. This may surprise you, but the doctors hired by insurance are not magically better than the ones treating the patient.

Yes, of course you're right. That's why my surgeon friend who works in oncology has to frequently waste his time calling insurance over denied claims regarding fucking treatments for cancer patients. Truly medically unnecessary, which is why they're pretty much always reversed and when they're not, he gets to tell the patient they are going to die because someone who has never met them denied their claim as medically unnecessary. Same goes for my friend in the PICU, except she gets the added bonus of telling a little kid's parents.

And my guess is it would have literally been cheaper for everyone involved for insurance to just pay for the $200 seat cover. Modern American insurance companies are capitalist enterprises providing a socialist benefit. And the doctors denying claims on behalf of the insurance companies are not seeing the patients in question so are basing their decision on questionable documentation and "industry standards" that are based on heavy insurance influence. All to maximize value for the company rather than ensure patient welfare, which is the fucking point of insurance.

There is plenty of abuse of the system through over billing, but somehow fucking Medicare is the most efficient health insurance system in America. If private insurance is so great, why are they more inefficient with worse outcomes?

If your wife has not seen or treated the patient, she has no basis to deny the claim as medically unnecessary. She has no idea what conditions the patient may have that would necessitate having a different seat cover. I get that you love your wife, but her job leads to significantly more pain than benefit.

She's a litigator, she treated it like court. Very effective when your opposition makes insane rants.

They're just so hungry hungry.

A. Cherry.

Too Many Secrets