Quote Originally Posted by cassiesmom View Post
One thing I would like to see change is the way services are paid for. (I work in a claims office) We received a claim for a service that is not covered under the insurance plan I work for. The patient had the service at a hospital in the PPO network, so the claims came in with the billed charges and the contracted rates. But the patient will not get to know the contracted rates - she will get a bill for the services at the billed charges, which are a LOT higher than the contracted rates. That stinks.
This happened to me. J had speech, covered at 20 visits a year, cause anyone knows that speech problems clear up on that 20th visit, duh!

Anyhow, I asked if I could continue the service, at the discounted rate, and was denied. Add that on top of the fact the insurer did not count the payments made for additional speech treatment as medical care going towards the significant deductible, and things stunk.

I think one of the largest lobbying groups in DC is the insurance industry. Too bad, as that will keep things the way they are for a long time now.