Our healthcare system is a constant news topic today as the government looks at ways to make it more efficient and patient-friendly. One of the issues with the system is that of insurance. There are many statistics being tossed around noting how many have and do not have insurance, etc. What is sometimes overlooked is the burden the current healthcare insurance system puts on the overall healthcare system and thus those that do not have insurance.
Per research conducted a few years ago by the American Medical Association it is quite common for insurers to reduce, delay and deny claims that should be authorized. Sometimes this is due to errors in how the medical providers handle coding and other administrative tasks. Sometimes it is due to errors by the insurance company.
A coworker recently shared a story describing how one such incident recently occurred. The insurer pre-authorized the treatment, then told my associate they would not be paying for it, then capitulated and took responsibility for the claim. Sometime later a collection letter was received. Luckily, having made the calls from a business communications system that includes call recording, my coworker was able to produce documentation of the agreements to resolve the issue and finally get the insurer to pay the medical provider.
Seems to me that part of the problem - maybe the majority - has to do with accountability. Isn't that what documentation and call recording are all about?
Per research conducted a few years ago by the American Medical Association it is quite common for insurers to reduce, delay and deny claims that should be authorized. Sometimes this is due to errors in how the medical providers handle coding and other administrative tasks. Sometimes it is due to errors by the insurance company.
A coworker recently shared a story describing how one such incident recently occurred. The insurer pre-authorized the treatment, then told my associate they would not be paying for it, then capitulated and took responsibility for the claim. Sometime later a collection letter was received. Luckily, having made the calls from a business communications system that includes call recording, my coworker was able to produce documentation of the agreements to resolve the issue and finally get the insurer to pay the medical provider.
Seems to me that part of the problem - maybe the majority - has to do with accountability. Isn't that what documentation and call recording are all about?
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