Should you go to social media to get your insurance denials paid? This woman did.

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When the healthcare system doesn't work and your insurance company is part of the problem, who can we trust? For many patients, nobody unless you find someone who really cares about you personally.  For now, conveyor belt medicine which is the corporate version of healthcare where nobody knows your name or cares is what we have.  Truthfully, capitalism has ruined healthcare in the USA. Even my wife recently had a precert done for cardiac screens that were denied when her primary doctor requested them, requiring her to see a cardiologist first. I would be the first to tell you that medical providers order too many tests, especially MRI because they lack the skill to do an adequate history and evaluation for many musculoskeletal problems, but there are life-saving treatments that can offer hope to people suffering from a chronic condition. I would also be the first to fault drug companies that prefer to treat instead of cure since a cure means that they are no longer going to be paid.   Part of the problem is also the cost, as drugs like Wygovy can help people lose weight but most insurers deny it partly due to the cost which is 14x more costly here than in Brazil ($1400 vs. $100 per month). When faced with a health problem a certain drug could relieve, this woman fought back through social media forcing the insurer to pay for the care.   While I have no idea if this treatment helped, she was able to get approval by publicly pressuring and shaming an insurer. We must always fight to get what we paid for with any insurance including homeowners, travel as well as other types of insurance.  With health insurance, the fight is often about quality of life or just getting what we pay handsomely for; healthcare. Isn't it about time the US does something to improve the health of America in the name of Universal Healthcare that works? Check out this article that was featured on NBC News.

Doctors, patients try to shame insurers online to reverse previous authorization denials

Lauren Sausser | KFF Health News August 22, 2023 Sally Nix was furious when her health insurance company refused to pay for the infusions she needs to ease her chronic pain and fatigue. Nix has struggled with a combination of autoimmune diseases since 2011. Brain and spinal surgeries didn’t ease her symptoms. Nothing worked, she said, until she started intravenous immunoglobulin infusions late last year. Commonly called IVIG, the treatment bolsters her compromised immune system with healthy antibodies from other people’s blood plasma. “IVIG turned out to be my great hope,” she said. That’s why, when Nix’s health insurer started denying payment for the treatment, she turned to Facebook and Instagram to vent her outrage. “I was raising Cain about it,” said Nix, 53, of Statesville, North Carolina, who said she was forced to pause treatment because she couldn’t afford to pay more than $13,000 out of pocket every four weeks. “There are times when you simply must call out wrongdoings,” she wrote on Instagram. “This is one of those times.” Read more