The Coverage Report™

Insurance companies have rebranded themselves as healthcare partners, which is like calling a cat an emotional support animal after it knocked over your coffee mug for the third time today.

Insurance companies are here to optimize profits, not your health. Calling them healthcare partners is like calling mosquitoes your camping buddies.

American healthcare: Step 1: Go to the ER for severe pain. Step 2: Get hit with a $10,000 bill. Step 3: Spend months begging insurance to cover it. Turns out, the real treatment isn't medicine, it's endurance training in bureaucracy.

Insurance companies will pay for your Viagra but not your insulin. Apparently, it's more important to love harder than to live longer.

Your insurance company calling you a 'valued member' is like your kidnapper offering you a courtesy snack while renegotiating your ransom terms.

Insurance companies denying care at the speed of light. Patients waiting weeks for appeals. Doctors caught in the middle. If this is healthcare innovation, I think I'll pass.

Insurance companies explaining why they denied your life-saving treatment: It's not about the money, it's about *ethics*. No, actually, it's just about the money.

Insurance companies say they're preventing unnecessary care. Translation: We've decided your health takes a backseat to our quarterly profits.

Insurance companies say they're your partner in health, but it feels more like a bad group project where they take the credit while you do all the work... and still get billed for it.

American healthcare: where insurance companies profit by denying claims, middlemen inflate drug prices, and patients ration insulin with grocery money. And yet we're told this is the best system in the world.

American healthcare in 3 acts: - Patient gets a bill for $50,000 after a hospital stay. - Insurance reluctantly covers $5,000 after weeks of review. - Patient sets up a GoFundMe to beg friends and family for the rest. System's working *perfectly.*

Could someone tell me what would happen to a doctor defrauded Medicare? Oh yea, loss of license and jail.

Big Insurance denies your claim, tells you it doesn't meet medical necessity criteria. Your doctor disagrees. Your symptoms disagree. But hey, a high school graduate with a flowchart at a call center overruled everyone. Welcome to American healthcare.

Hospitals charge $200 for a single Tylenol. Insurance denies it because cheaper alternatives exist. The cheaper alternative? Suffering in silence while clutching your credit card. Welcome to the American healthcare system.

American was force to change her health insurance to Blue Cross Blue Shield She says the have denied every prior authorization that was previously approved Her 11 year old child’s treatments needed to keep her alive all have been denied, 100% of them “Every single new prior authorization that we have to get again for continuation of treatment, not new treatment, continuation of treatment. You have denied a hundred percent of them” “You are withholding life sustaining treatment from my 11-year-old child. You have denied the treatment that we need to keep her alive. Treatment that she has been on for years, not new treatment. Treatment she's been on. And I have spent hours, if not days on the phone with you” “I have decided that you are the most vile insurance company on the face of the planet.”

@DrMcFillin How many kids get tested and don’t come back with a diagnosis of ADHD?

A nurse practitioner in Illinois prescribed psychiatric drugs to nearly 4,000 Medicaid children in one year. Her reimbursement for ADHD drugs alone: $203,711. She has been the state's top prescriber for six consecutive years. No investigation. No interruption. No consequence. I published the full investigation. Link in comments.

The American healthcare system is the only place where you can pay premiums every month, just to find out your insurance card doubles as a Not Covered sign when you actually need care.

The U.S. healthcare system is the only place where you can leave the Emergency Room in crippling debt... for an emergency you didn't even get treated for. Welcome to America: land of the co-pay, home of the bankrupt.

The American healthcare system: Where your treatment plan is subject to change based on the mood of the insurance adjuster reviewing it. Evidence-based medicine? Only if evidence includes a denied claim stamped with Did Not Meet Criteria.

The healthcare system in America is like a house of cards built on an active fault line. You don't know how bad it is until you're the one holding the bill, and wondering why your house collapsed.

Utilization management is like a toddler with crayons: they'll draw arbitrary lines everywhere and expect you to just live with it.