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MD’s sharp critique: Here is what’s really going on re care denials

On Behalf of | Apr 3, 2018 | Denied Insurance Claims

Do you want to peruse a soft and conciliatory communication from a seasoned physician weighing in on the causes and effects of denied health care for patients?

If so, don’t read an opinion piece recently crafted by a doctor writing in an online publication advocating for the smooth and logical delivery of medical care to the general public.

Because Dr. Kimberly Becher is a bit frustrated and has identified — with a bulls-eye — the target she says squarely deserves blame for a health care system that “is failing our patients.”

Nemesis number one is the insurance industry and its legions of carriers that Becher flatly insists deny necessary care routinely in an illogical and sometimes even flippant way.

The result of that is often this, she says: tardy approval ultimately granted after successive go-rounds of denial and repeated submissions. Affected patients are often in worse condition when they finally get the same treatment that was recommended for them all along. Moreover, they must often hurry to an emergency room or be checked into a hospital to get it because it is well past due, which jacks up costs that an insurer states it was trying to control.

And, of course, there is an additional source of ire for Becher and scores of thousands of her credentialed peers across the country. That centers on the irony that knee-jerk denials of so-called “first-line” treatments recommended by medical experts often issue from bureaucrats with scant or no knowledge of medicine.

The anger in Becher’s calling out of insurance companies emerges clear enough in just the headline she penned in her recent article.

“Jumping through hoops wastes my time, worsens outcomes,” it says.

Routine insurance denials fundamentally harm American medical care, Becher asserts. The public needs to become more aware that insurers “often aren’t making the right choices for patients.”