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Started By
Message
re: UNH's UnitedHealth CEO shot and killed
Posted on 12/4/24 at 9:30 am to JohnnyKilroy
Posted on 12/4/24 at 9:30 am to JohnnyKilroy
quote:
It was the thread where you later admitted to still masking if it was convenient (i.e., you still masked on planes because driving wasn’t convenient enough to stick to your anti-masking principle)
Something tells me I was more likely defending the 2nd Amendment and it’s purpose, and you’re taking me out of context.
1
Posted on 12/4/24 at 9:30 am to WeeWee
quote:
I amended the chart to say "Hemoglobin A1C reduction despite max dosage of metformin and Farxiga. GLP-1 agonist is medically warranted as next step to achieve additional hemoglobin A1C reduction." I had the prior authorization person at my office rerun the claim and United approved it. Which reminds me I need to go tell that NP to check the patient's chart and see what I did to get Ozempic approved for the patient and to start doing that.
So fraud?
Posted on 12/4/24 at 9:31 am to HeLeakin
I’ve seen this movie
Posted on 12/4/24 at 9:32 am to metallica81788
quote:
This is also a huge problem - many of their medical reviewers don't practice or are retired and trying to get extra cash on the side. They are mercenaries and beholden to the "guidelines" of United or Evicore, whether appropriate or not. It's shameful - they went into medicine to help people and are now directly involved in delaying or denying care.
These "peer to peers" in my field often are initiated by some nurse who doesn't read my note, then the MD to discuss the case isn't even in the same field and has no clue what is appropriate. Does it get approved? Mostly yes but we don't have time for that bullshite.
That is where attaching the guidelines and studies comes into play. My classmate told me that the nurse who reviews the chart still won't read it before sending it to the medical review officer, but if the medical review officer sees a long medical explanation for something and an attached guideline they will approve and try to save the company $0.02 on another chart instead of reading it and initiating a peer to peer.
Posted on 12/4/24 at 9:33 am to OMLandshark
quote:still posts?
OMLandshark
The Alex Jones of the O-T. 
Posted on 12/4/24 at 9:36 am to ghost2most
quote:
Pharam is up there too
Not sure if you intended this portmanteau of Pharma and Haram, but it fits
Posted on 12/4/24 at 9:38 am to metallica81788
quote:
I've said it before I'll say it again - United is probably the most evil company in existence
Agreed. They treat providers like shite too. They are absolutely pain in the arse about claims and are horrific to deal with.
Not surprised this happened at all. Just that it took this long.
Posted on 12/4/24 at 9:39 am to Mingo Was His NameO
quote:
I amended the chart to say "Hemoglobin A1C reduction despite max dosage of metformin and Farxiga. GLP-1 agonist is medically warranted as next step to achieve additional hemoglobin A1C reduction." I had the prior authorization person at my office rerun the claim and United approved it. Which reminds me I need to go tell that NP to check the patient's chart and see what I did to get Ozempic approved for the patient and to start doing that.
So fraud?
In the state that I practice in and oversee NPs in, NPs require a collaboration agreement and have an MD/DO review 5% of their charts. That MD/DO has to attest the charts we review. We can add additional comments in the attestation. It is not fraud because everything I said is backed up by things documented in the patient's chart. Fraud would be saying that patient had failed to achieve adequate A1C reduction with metformin and Jardiance when the patient had not actually taken those medications.
Posted on 12/4/24 at 9:39 am to HeLeakin
After having to navigate my insurance co maze after an minor injury a few years back, I'm surprised this kind of thing doesn't happen more often. Especially considering a many users of healthcare are there because of potentially terminal conditions. Not much to lose in that instance.
Posted on 12/4/24 at 9:42 am to LSUfan4444
quote:
Which reminds me I need to go tell that NP to check the patient's chart and see what I did to get Ozempic approved for the patient and to start doing that.
What a scumbag.
Sorry for making sure the NPs that I have collaboration agreements with are actually doing what is right for their patient's instead of taking the easy way out because they do not want to do extra work. Wouldn't you want a provider to actually fight to get a medication approved if you were the patient?
Posted on 12/4/24 at 9:43 am to HeLeakin
Victim to the system, but that doesn't mean he wasn't a part of it.
A CEO's job is to maximize profit/shareholder value by all means while following the rules set forth by the industry/government policymakers, but the system has been infiltrated by lobbyists who've broken the firewall between "unbiased" policymakers and the "for-profit" policymakers. The CEO's doing his job based on decades of "how business gets done" mindset in large businesses in our corrupted form of capitalism. If he didn't, he wouldn't be the CEO making the FU money.
Prayers for his family/loved ones!
A CEO's job is to maximize profit/shareholder value by all means while following the rules set forth by the industry/government policymakers, but the system has been infiltrated by lobbyists who've broken the firewall between "unbiased" policymakers and the "for-profit" policymakers. The CEO's doing his job based on decades of "how business gets done" mindset in large businesses in our corrupted form of capitalism. If he didn't, he wouldn't be the CEO making the FU money.
Prayers for his family/loved ones!
Posted on 12/4/24 at 9:45 am to cgrand
quote:
you gonna put your money where your mouth is?
Nope, because I’m nonviolent and I also know that’s how you turn someone into a martyr. Fauci is disgustingly worshipped enough as it is, and I wouldn’t want to add to that.
I want a fair and internationally broadcast trial with everything declassified for this monster so people finally understand who he is and will go down as the single most loathed human being since Adolf Hitler.
This post was edited on 12/4/24 at 9:50 am
Posted on 12/4/24 at 9:45 am to HeLeakin
Like most Americans, I also dislike insurance companies. But the posts in this thread that appear to tacitly condone murder as a means of avenging class disparities are disturbing.
Posted on 12/4/24 at 9:47 am to REG861
quote:
Insurance companies have literally 0 to do with hospital issues.
Wrong times infinity. Hospitals can’t clear beds when qualified patients are denied coverage for external facilities for continued care. This causes all sorts of systemic issues.
Ok sure they don't have literally 0 to do with hospital issues, I meant hospital financial issues.
Do this for me, lets show some profit per patient charts here. Lets compare a hospital profit per insured patient compared to the average patient or compared to any number of other payment methods. Then lets start the discussion.
I'd love to be able to go to a hospital that ONLY took Insured patients just like you can only go to see a specific physician that ONLY takes cash patients.
Posted on 12/4/24 at 9:48 am to DmitriKaramazov
quote:
But the posts in this thread that appear to tacitly condone murder as a means of avenging class disparities are disturbing.
Welcome to the OT.
Posted on 12/4/24 at 9:48 am to WeeWee
I'd want an MD that was more concerned with the cost of care and directly how it relates to improved outcomes rather than doing what THEY think is right regardless of my out of pocket cost and the economic strain on the healthcare system. So in short, no. In that blanket question, my blanket answer would be no.
Posted on 12/4/24 at 9:49 am to DmitriKaramazov
quote:
Like most Americans, I also dislike insurance companies. But the posts in this thread that appear to tacitly condone murder as a means of avenging class disparities are disturbing.
I am not condoning murder. However, I am not surprised that he was targeted. There are a lot of crazy people out there and some of them have probably had to deal with United Healthcare. Again not condoning murder; just saying that I am not surprised.
Posted on 12/4/24 at 9:51 am to DmitriKaramazov
quote:
Like most Americans, I also dislike insurance companies. But the posts in this thread that appear to tacitly condone murder as a means of avenging class disparities are disturbing.
I don't condone it.
But people shouldn't be remotely shocked that this happened given how insurance companies have had no issue playing with people lives over a hospital bill.
Posted on 12/4/24 at 9:51 am to Mingo Was His NameO
quote:
Insurance companies have literally 0 to do with hospital issues.
quote:
by baldona
Easily one of the dumbest posters on this site
Then prove me wrong almighty one.
As I said, medical insurance companies are a major issue because they are the only ones paying the bills at hospitals to the point a profit can be made. Remove all the blood suckers from the hospital issues, and insurance companies would be much better.
Yes, they are far from ideal. But the problems with them will NEVER be fixed because they are facing an uphill battle before they start. I'm not for insurance companies, I'm against free healthcare for the leaches of society.
Posted on 12/4/24 at 9:52 am to baldona
quote:
Then prove me wrong almighty one.
I don’t need to, you’re doing that yourself by completely changing your own sentiment
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