In order to be a successful dictatorship, you must create a climate of fear. This means periodically arresting or intimidating innocent people and accusing them of serious crimes. Eventually, the accused is released with a warning. The theory is citizens who are afraid of committing minor infractions will not even think of doing something more radical in the future.
Anthem BC/BS Health Insurance is using a version of this technique. I received a letter yesterday. The letter accused me of charging for impacted ear wax removals at a frequency well above my peers. The letter told me I needed to call them immediately to discuss this with their “Physician Education” team. I pictured a uniformed patrol would soon be dispatched to detain me in a “Re-education Camp,” designed to get my mind right through various punishments and hard labor.
Let’s talk a bit about ear wax: We audit our charges regularly and my use of the charge in question is in line with other providers. I actually am not fond of the procedure which can often be time-consuming and difficult. Typically, the issue comes at the end of a complex visit. On exam, you find the person has ears that are really packed tight with ear wax, requiring a combination of irrigation, scooping and manual extraction. Great care is necessary. Yet, the relief expressed by patients at the end of the process is rewarding. Quite simply, people find they are no longer deaf!
Often, the patients are sent in by Audiologists who are not permitted to remove the ear wax. The alternative is to send people to an ENT doctor, which has a wait time of many weeks and a price tag that is quite high for the patient and the insurance company. Rarely is such a referral medically necessary.
I spoke with our practice consultant and Anthem has been sending out a lot of these letters for similar bogus reasons. Often the letters reference charges which were not even submitted by the doctors in question. So, as demanded by the letter, I called the number and spent 40 minutes on hold. A nice lady eventually came on the line and told me not to panic. They just wanted to make sure I was submitting the proper documentation to justify the procedure. She didn’t know what specifically that was and nobody had even seen my documentation for the ear cleanings (which I am careful to document in each note). It was kind of a good-hearted warning to keep me off balance in case I had even an inkling of trying something more devious in the future.
Thus, Anthem is maintaining fear among its subjects to maintain its tyrannical grip.