Quote Originally Posted by mrspunkysmom View Post

But the insurance company is left out of it. and you can't sue the doctors. I wonder if behaviors would change if the doctors didn't have insurance companies to back them up.


There is TONS of stuff that goes on behind the scenes of a hospital visit/stay. I worked for an HMO, so the billing is a tad different.

Doctors have to submit paperwork to the insurance then the insurance has to claim with the Gov't. How much time does that take?

At my prev employment the ins/billing'coding was all done within the HMO, a bit faster, but still, the government is still involved.

If you want to find out about how a HMO/hospital/doctor submits a claim for patients, check out what a ICD-10 and DRG is.

A doc/hospital submits a code for your illness (The insurance being the go between) and the government pays the AVERAGE of the stay-depending on the code it's submitted under.

If you go in for an appnedectomy and get an infection you are seriously screwed. The facilities will do their damndest to 'advise' the physician that they must discharge you when the DRG says you need to go home.

MY former HMO told the docs NOT to order tests in order to keep costs down.

I'd tell the story of my GF's son who broke his arm and the doc told the parents, "aspirin and ice"! The child wailed thru the night and a SECOND visit to the MD, with an xray- confirmed a broken bone.

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An HMO runs just like gov't provided ins-you sign away your rights to sue or persue any legal action, should you want to have a resolution for a problem, call their ombudsman and they will gladly try to help you. THe operative word is TRY.


The real problem is the 'news blackout' about how and why med insurances are run. I do not mean to demean anyone on the site or this thread but-

Y'all needs to do your homework.

The way the president, the congress and the house or reps are trying to curry your favor about how and why the insurance/health care need to be voted on and passed make me laugh at the people who really want to have their government involved in your health and care.

I can probably go back and dig up quite a few posts about how DHS is looking at or private computer files and the anger and paranoia that people voiced in those posts, Yet, with a new regime and even more government scrutiny regarding blood tests, pap smears, Tb tests, prostate checks and a slew of other 'private' tidbits of your life they plan on housing in a HUGE data base-the same "the sky is falling" liberals have no problem with that.

Wonderful and amazing!

The hilarity comes at your expense.

A community organizer who want the government to change, is annointed as the end all, be all answer to all the problems we have.

We just have to let him become the new government and all the stupidity of the past gov't. will be resolved.

Repeat after me.

When this CF of an experiment fails, I will be true to my fellow citizens and apologize for being starstruck and claiming that "anyone but Bush" was good for the country.

You wanted it, you got it.