Insurance company health care denial (60 minutes)



30 of claims are routine but the insurance industry aggressively reviews the cost of chronic cases long-term care is often denied by insurance company doctors who never see the insurance company stop paying after 6 weeks 6 weeks pretty much was it for them they were done and if you know about a mental illness don't cure mental illness in six weeks the health insurance company was Anthem second largest in the nation an anthem reviewer found Catherine should leave the hospital because she had put on enough weight her doctor warned that she was desperate to shed those pounds they were telling the insurance company she needs to stay here she needs more long-term treatments she isn't ready for this the insurance company overruled the doctor Katherine West came home as an out did it make sense to you that a doctor at the insurance company was making these decisions based on telephone coverage they didn't observe my daughter you're talking about a psychiatrist a pediatrician a therapist who observe my daughter on a daily basis but some nameless faceless doctor is making this decision and I was furious because basically to me he was playing God with my daughter's life now look at how Ashley's care was denied this log shows dr. Tim Jack a psychiatrist working on behalf of anthem called Ashley's doctor three times in 32 minutes one call was disconnected he left two messages dr. Jack waited 22 minutes for a callback and then denied coverage from the first call to denial 54 minutes speaking to no one why so fast well it may be in part because many insurance doctors are paid by the case dr. jack is a contractor who gets forty five dollars per patient in court records dr. jack says he does 550 reviews a month so working from home that comes to 25 thousand dollars a month we spoke to 26 psychiatrists from across the country and everyone brought up doctor Jack's name some called him dr. denial this is a recording of dr. Jack telling a physician that a patient's level of care should be lowered because given what his current progress is and his current symptoms are he can't be managed at a lower level get there as effectively as in an intensive outpatient program you know doctor I just want to say that I was spoken to you in so many different occasions and with so many different kinds and I've never really had you know a positive outcome as far as authorization from you so I just needed to bring back to your attention this is not a personal matter but appears to me this criteria so we found dr. Jack's denial rate average 92% in one six month period in 2011 but

1 Comment

  1. I am bringing forth Congressional action regarding this very subject. I need to hear from others and can email me or FB messenger. Terrible the obstruction and abuse of power and money.

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