Insurance resists obligations to pay

THE PEOPLE SPEAK: Insurance resists obligations to pay

Muskogee Phoenix
March 13, 2009 04:35 pm

— Insurance companies cannot be trusted to make unbiased decisions in deciding to pay a claim as long as they are unregulated.

The degree to which their profit motives drive behavior ranges from slightly sleazy to illegal to immoral are the same motives that drive Oklahoma’s GOP by denying special needs insurance mandates which eat into the profits of Oklahoma’s insurance monopoly and most certainly reduce the amount of PAC money lining the pockets of the GOP.

Insurance companies have a long history of non-payment to providers for services rendered. They know a certain fraction of rejected claims will be written off by the doctor or paid by the patient, which is pure profit for them.

A class-action suit in Connecticut alleged an industry database designed to provide data on “usual, customary and reasonable” charges was manipulated by United Healthcare to underpay physicians for out-of-network services.

Insurers delay/deny authorization for treatments or impose difficult pre-authorization requirements, since a procedure that is not performed is one they don’t have to pay for, which represents increased profits. Insurers are pursuing their own self-interest so their individual bottom line is protected.

The deliberate policy decisions to obstruct, delay and deny payment for services increases profits. Insurance companies are padding the pockets of the Oklahoma’s GOP so they do not have to cover the costs of diagnosing and treating children with autism. Anytime an insurance company must pay a claim, it eats into their precious bottom line and of course Oklahoma’s GOP PAC money.

Robyne Rohde
Edmond

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