[HN Gopher] Insurance companies fill their networks with 'ghost'... ___________________________________________________________________ Insurance companies fill their networks with 'ghost' therapists Author : apwheele Score : 40 points Date : 2023-10-04 21:59 UTC (1 hours ago) (HTM) web link (www.seattletimes.com) (TXT) w3m dump (www.seattletimes.com) | didgeoridoo wrote: | My wife is a clinical psychologist who used to take insurance. | She got tired of not being paid for months for patients she saw. | Legally they have 90 days to pay you, but in practice it's closer | to 4-5 months. Every January they claim to have "computer | problems related to the new year" and simply lose huge numbers of | claims, requiring you to resubmit -- oh that claim is more than | 90 days old even though it was their system that "lost" it? | Sorry, can't submit! Guess you just worked for free! | | She takes cash now. It was an abusive system and I'm not | surprised it's falling apart. | jwie wrote: | It's unlikely this is as interesting as the headline suggests. | | Maintaining a list of professionals is challenging. There are | very simple input problems with this kind of data. | | The professional, in this case a therapist, but it really doesn't | matter what they do, just isn't going to keep their portal | updated on the insurance network aggregator. | | The insurance companies can't make the anyone update their | listing, and the professionals don't have incentives. They're | full up on work so there's no real need for them to do anything | to get clients. | | This is a bog-standard supply and demand problem. | neonate wrote: | http://web.archive.org/web/20231004220011/https://www.seattl... | | https://archive.ph/Nl7gj | PaulHoule wrote: | I wouldn't necessary blame the insurance. My primary care doc | gave me 10 referrals to psychiatric nurse practitioners but zero | were taking new patients. I asked someone who'd written review | articles on my condition to do the same and he said he would but | I think he did some looking and came up short and ghosted me. | chimeracoder wrote: | > I wouldn't necessary blame the insurance. | | Why not? They're the ones who are gatekeeping the product | (their network) at the same time as they're selling access to | their network (this is considered one of the "features" on | which insurance companies compete and sell their product). | | Not to mention that, as mentioned in the article, insurers are | _legally required_ to maintain a sufficiently large network to | enable their patients to receive care in a timely manner. | | If insurance companies want to restrict patients and limit them | to seeking care from providers within a preapproved, | artificially limited network, then it's totally fair to | criticize them for not ensuring that their network is | sufficiently large and accessible to be practically usable by | patients. | toomuchtodo wrote: | Insurance is collecting premiums for care that can't be | provided. I blame them. | notacoward wrote: | Yes. All the time. First you have to find a therapist that | actually exists. Then you need to find one who returns a simple | email or phone call. Then one who is willing to take you on as | a client, and finally one who actually has the tools to help. | And each step is _hell_ for someone with any of several | conditions that might have been why they were seeking a | therapist in the first place. It 's no wonder we have a crisis | - if that's even the word for something that has been going on | so long. ___________________________________________________________________ (page generated 2023-10-04 23:00 UTC)