Anthem Bypassing Doctors

Here is an incredible tale, that seems like a fable, until you realize that an insurance company is involved. Anthem is being sued by doctors because they are “paying patients directly in an effort to put pressure on health care providers to join their network and to accept lower payments”. What does that look like? Well,

  • A woman received nearly $375,000 from her insurance company over several months for treatment she received at a California rehabilitation facility.
  • A man received more than $130,000 after he sent his fiancée’s daughter for substance abuse treatment.

In fact, Anthem supposedly sent “more than $1.3 million in payments to patients — money, the suit claims, that is owed to the facilities that treated people with addiction and mental health problems.”

What are the chances that:

  • These patients will give the money to the doctors?
  • These will use this money to treat their addiction with their own remedies?

Before you answer that, please know that patients who “receive money from insurers typically cannot be held criminally responsible if they never turn the cash over to their provider. But the patients can be held financially responsible.” Yeah, so that money is not coming back.

The bottom line is that this is about “out-of-network” care that insurers hate. So, they are torturing doctors to go chase the money in order for get them to bend the knee. And they have done it before and have been sued for it before.

Tell me why we have third parties in the middle of our healthcare system again? And, no, I don’t want a government run system. Our only hope is a proper free market.

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