re: United Healthcare Buying People's Health

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paying for unnecessary services

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Says you or the patient? If it was your mother or wife, you'd think differently about those "unnecessary" services. What's the point of having insurance if not to protect us and help out in times of medical need?

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Could be due to your narrative skills? Could be due to the fact that a stroke patient is better off in a different setting (CMS guidance agrees)?

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Has nothing to do with his narrative skills and everything to do with cost of providing care. They'd rather save that money!

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Says you or the patient?

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Says medical practice guidelines

Just saw your other reply about facilities not accepting traditional Medicare. That’s crazy. Straight Medicare patients are the first people accepted. Facilities and home health companies take those quick.

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Straight Medicare patients are the first people accepted. Facilities and home health companies take those quick.

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Absolutely CORRECT Sir!!

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They'd rather save that money!

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That’s the reason AET, UHC, and HUM have insanely profitable MA lines of business and traditional Medicare will be insolvent soon. The point is to deliver value to shareholders, not run a charity.

If the doctors and facilities truly believe a patient should be in an IP rehab setting, they are free to admit them knowing they won’t get paid. I don’t see them volunteering to take a hit on something they claim is medically necessary, yet they expect the payor to pay for something they think isn’t needed (in violation of their fiduciary duty to the owners, mind you)

For inpatient rehab, straight Medicare will get in the same day that the rehab doc allows. For Medicare ppo’s, they need prior authorization. And many will be denied, or just shuttled to a SNF. Or if they go to acute inpatient rehab and need SNF afterwards, they won’t authorize the SNF admission.

In other words, go straight Medicare.

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For inpatient rehab, straight Medicare will get in the same day that the rehab doc allows. For Medicare ppo’s, they need prior authorization. And many will be denied, or just shuttled to a SNF. Or if they go to acute inpatient rehab and need SNF afterwards, they won’t authorize the SNF admission

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You sir know exactly what you are talking about and you are correct!

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In other words, go straight Medicare.

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Right On!

My parents had peoples. They could only draw their blood at certain labs, and their doctor got denied to try and get an MRI that my dad needed. The doctor said he could have gotten it covered very easily if they had a different kind of insurance. He had to go see a spine specialist to get the MRI covered. It seems very difficult working with these advantage plans, from my experience.