Physician’s Weekly co-hosted the second part of a previous #PWChat with Dr. Linda Girgis, on Tuesday, December 19. The topic continued from last month on how insurance companies are harming patients. You can read the Part I recap here.
Our latest interactive Tweet Chat was based on Dr. Girgis’ blog post.
Below are the highlights from the chat. You can read the full transcript here, by scrolling down to the corresponding responses.
Click here for a look at our #PWChat schedule and recaps.
Question 7
Q7: Who is best served by health insurance companies?#PWChat pic.twitter.com/OlMHoe1kU5
— Physician’s Weekly (@physicianswkly) December 18, 2018
A7: CEOs of health insurance companies, shareholders, & hospitals are best served by health insurance companies. #PWChat
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
Hospitals price gouge patients who have health insurance. Cash pay is often 1/5th of price billed to insurance, Medicare & Medicaid #PWChat
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
#PWChat who benefits?
1. insurance companies
2. insurance companies
3. insurance companies@RadiologyChicks @sheMDTweets #irad— A Solberg MD (@AgnesSolberg) December 18, 2018
Indeed! Patients are being harmed. #PWchat https://t.co/RU1PU0lNId
— Linda Girgis, MD (@DrLindaMD) December 18, 2018
Question 8
Q8: Do you have any stories of patients who were harmed by a health insurance company decision that you can share?#PWChat pic.twitter.com/2QovrqgQc6
— Physician’s Weekly (@physicianswkly) December 18, 2018
A8: Medicaid MCO tried to deny lifesaving buprenorphine for a pt, delaying treatment due to needing to write them a letter & present evidence why they were wrong #PWChat Too many stories to tweet
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
A8: Pt was stable on a med for 4 yrs when insurance company decided not to cover any longer due to formulary changes #PWChat
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
Sometimes it’s harm and sometimes it’s stress – I personally have been sent to collections while waiting for insurance to fix a mistake (by the hospital where I work). #PWChat
— A Solberg MD (@AgnesSolberg) December 18, 2018
Personal experience w/this: in dispute w/ins co since June 2017for pre approved surgery. ~75K out of pocket but started at >200K. Forced to file in court for wrongful & deliberate denials as well as bad faith across the board on handling of all claims. Like a shell game for 18mo
— Erica Steussie (@erica_steussie) December 18, 2018
Refusal to pay for EVIDENCE-BASED proven procedures (Like UFE and PCS embolization) – they claim it’s experimental. It’s not. It works. @SIRspecialists #iRAD @Aetna @RadiologyChicks
— A Solberg MD (@AgnesSolberg) December 18, 2018
A8. In HIV clinics sometimes clinicians have to reluctantly start people on second line ART or go through hoops because insurance would not cover first line (the second line used to be first line). #PWChat
— Jasmine R Marcelin, MD (@DrJRMarcelin) December 19, 2018
Question 9
Q9: Does the health insurance industry need reform? Why/Why not?#PWChat pic.twitter.com/mk2xGRpRct
— Physician’s Weekly (@physicianswkly) December 18, 2018
A9: In fairness to them, they have been asked to take on too much. We need to make insurance insurance again. 3rd parties should have no role in affordable care such as primary care. #PWChat
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
A9 It’s always been my opinion that U.S. healthcare insurance is one of the greatest cons of man. Yes, it needs reform. #PWChat
— ShereeseM, MS/MBA (@ShereesePubHlth) December 18, 2018
Question 10
Q10: Is single pay healthcare a viable option for reform? Any other viable options?#PWChat pic.twitter.com/UAGTABbe1v
— Physician’s Weekly (@physicianswkly) December 18, 2018
A9: @NeuCare wrote this, which I think could work https://t.co/PH4UtXGcr9
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
Question 11
Bonus question b/c we still have a few minutes…
Q11: Do you tell patients about your opinions regarding coverage determinations? Why/Why not?#PWChat
— Physician’s Weekly (@physicianswkly) December 18, 2018
A11: Yes I tell them & involve them. I remind them that they pay for the insurance & need to act like the customer…i.e. complain, make noise on social media, etc. #PWChat
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
A11. We often make decisions on meds and testing together based on insurance co-pays and whether deductibles are met. I’ll admit I don’t know a lot of the back end of insurance-speak but I rely heavily on my social workers and pharmacists to help #PWChat
— Jasmine R Marcelin, MD (@DrJRMarcelin) December 19, 2018
Question 12
Another bonus question!!
Q12: Do you have any work-arounds to get around insurance denials?#PWChat
— Physician’s Weekly (@physicianswkly) December 18, 2018
A12: We dispense meds at my #DPC practice & save pts time & money. Planning to add x ray & ultrasound in 2019 pic.twitter.com/HQK9FkjphL
— Molly Rutherford, MD (@UnbridledMd) December 18, 2018
No, I only try to provide detailed documentation. That being said, I almost never have denials. 😬
— Kelly Cawcutt, MD (@KellyCawcuttMD) December 18, 2018