Stunning admission by Aetna may reshape insurance industry
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1   Tenpoundbass   ignore (6)   2018 Feb 12, 12:05pm   ↑ like (2)   ↓ dislike (1)     quote      

Shut them all down.

Doctors will suck your dick to do your surgery for what ever you can afford.
2   zzyzzx   ignore (1)   2018 Feb 12, 12:08pm   ↑ like (4)   ↓ dislike (1)     quote      

California's insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients' records when deciding whether to approve or deny care.
3   Patrick   ignore (0)   2018 Feb 12, 12:52pm   ↑ like (1)   ↓ dislike (0)     quote      

"If the health insurer is making decisions to deny coverage without a physician actually ever reviewing medical records, that's of significant concern to me as insurance commissioner in California -- and potentially a violation of law," he said.
4   TwoScoopsPlissken   ignore (0)   2018 Feb 12, 1:11pm   ↑ like (2)   ↓ dislike (0)     quote      

Absolutely no surprise. and the Insurance Commish and the Attorney General of California will strike a deal with Aetna. You'll find both in nice cushy jobs later on.
5   zzyzzx   ignore (1)   2018 Feb 13, 7:02am   ↑ like (1)   ↓ dislike (0)     quote      

Article did not bother to lookup appropriate laws to see if a nurse is an OK decision maker.
6   Sniper   ignore (10)   2018 Feb 13, 8:42am   ↑ like (0)   ↓ dislike (0)     quote      

zzyzzx says
to see if a nurse is an OK decision maker.


My wife is a RN. When she worked in the medical treatment area, 9 out of 10 times, the nurses told the doctor what to do for standard treatment for the patients. The nurses ran the offices and treatment plans, not the doctors.
7   Sniper   ignore (10)   2018 Feb 13, 8:43am   ↑ like (0)   ↓ dislike (0)     quote      

zzyzzx says
California's insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients' records when deciding whether to approve or deny care.


zzyzzx says
Article did not bother to lookup appropriate laws to see if a nurse is an OK decision maker.


When I was working, I dealt with a lot of different private insurance companies getting pre-authorizations for the equipment I was selling. In all cases, I dealt with a inside nurse who was handling the medical reviews. The nurses did all the approvals, I never spoke with a doctor, and they never said the approval had to be signed off by a doctor. They made the determinations.

Even with Medicaid, the local office used nurses to go out and do evaluations for authorizations. I would occasionally stop at their local office, who had a doctor overseeing the region, and discuss the authorization with him for really special situations. But for all normal approvals, it was the nurses that handled it all.

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