Rant of the day: Insurance Carriers and Healthcare in General

[LegendKiller]

Last year I finally had my knee permenantly fixed. It involved moving my patellar tendon and screwing it back down. I went through roughly 4mo of rehab, three times per week. This all related to a car accident 9 years ago, which had double coverage, so I was able to fund both surgeries through auto insurance.

I have finally realized, after all is done, how stupid our medical system is.


Case 1: My doc wrote a script for a "custom" knee brace. I went to the brace place, they said it cost $3,000 billed through insurance. I told them that they could bill me and I would submit it to insurance. They billed me $1,000 since I was "out of coverage". They stated they give cash customers "discounts".

I informed State Farm of this, they said that if I did that I would have to cover the brace myself if they deny the 3k first. I asked them why they would get chaged 3k. It is because they cannot "renegotiate" prices over state lines.

I talked to my doc who said "screw it" and had me go with an OTC brace, which works fine for me.


Case 2: I ran out of SF insurance coverage (blew through 40k) on my last therapy session (each cost $260 submitted to SF) and my last doc visit. I submitted both to my primary care.

Both claims went through today. I checked them and found out that Aetna "negotiated" with the PT place down to $69/session instead of 260. Of course, I have to pay $30 for each, 60 total.

Now, judging by how many times I went the arschlochs at the PT place overcharged SF by $9k since they couldn't "negotiate".


That pisses me off so much. They overcharge and now I have to pay $60 because they scam the system. :angry: :angry:
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[Showtime]

Yep, they suck ass.

I remember when some idiots caused an accident to collect money. It was a big scam going on in LA where they would jump into your lane and slam on their brakes. The Lawyers and the Doctors would make lots of money and the people causing the accident would make several thousand dollars for their hard work and for risking theirs and other innocent peoples' lives. At first I avoided the accident but got rear ended and clipped the 5 "business men's" car. If I didn't turn out of the lane, I probably would haved died because the cars behind me hit me and pushed me 3 car lengths past the accident and then totaled the scammers car. Around 5 or 6 cars involved. My insurance wanted to settle and I had to threaten to take my insurance to court before they would go and fight it. Scam artist never showed up in court and insurance saves 100k or so. Do I get a lower rate or anything for what I made them do? My rates went up and just like when a drunk idiot almost killed me, I end up paying out of pocket. My drunk driver accident, btw, makes your insurance story seem nice.

Yeah, they are all idiots and it's all one big scam to separate us from our money. I believe in God, simply for the hope that he will build a special place in hell for those people.

[Gothic Girl]

Showtime, Do you know if they ever catch these scam artists?

[Showtime]

I believe a few big and small rings were shut down. They involved shady law firms (lol) and shady medical centers. Most of the time the people accused of causing the accidents would just disappear and not too many were prosecuted. A few did die attempting to do this and I assume some of thier families made out if there were no witnesses to show what the scammers were intending. There were a couple of names for the scam, swoop & squat.
Swoop-and-squat:
An insurance fraud term for a type of contrived collision. A vehicle pulls into another's path and slams on its brakes, causing the other vehicle to rear-end it. The riders in the front vehicle then file fraudulent claims for whiplash.
From a quick search:
http://www.motherjones.com/news/feature/1993/09/craddock.html

What was funny was that before the accident I had safely changed lanes and I noticed the 3 dudes kept looking back and finally just slammed on their brakes. It was completely clear in front of them. It happened so fast that because of my car ending up in the front, the real business people (who the scammers were trying to get) asked me why I slammed on my brakes. The Highway patrolman was an idiot and wrote up the accident like it was all of our faults and made no mention of me stating that it was clear and they just slammed on their brakes. After the accident, I went to my bosses house and they were showing news of the latest insurance scam in LA. It was like a lightbulb went off and it all fit. Pathetic what people will do for a buck.