Diraj Karnani

Rheumatologist. Father. Husband. Son. Questionable taste in humor.

[Diraj Karnani @DKarnani]

https://t.co/36Q7CN9qIU

@Jason partial explanation behind healthcare costs rising.

[Diraj Karnani @DKarnani]

@Nenaadvocacy @WI4Patients @mcuban

[Diraj Karnani @DKarnani]

@HealthcareREguy Why not California? 😂

[Diraj Karnani @DKarnani]

@mcuban Yes and before you’re able to figure out how to dispute it if you don’t pay them back in a “timely fashion” they recoup funds from future services from other patient visits under same health plan.

[Diraj Karnani @DKarnani]

@mcuban Tried contacting state insurance commissioner in CA….they don’t care if your solo independents. They just defer to insurance company. It’s a joke

[Mark Cuban @mcuban]

Talking to independent physicians, it's obvious that the big insurance carriers are doing to them, what their PBMs are doing to independent pharmacies.

They deny, underpay, slow pay, clawback, and create administrative mazes, knowing their victims don't have the time or resources to fight.

Why ? By putting financial pressures on physicians and pharmacies, it makes them more likely to sell their businesses to them , close their doors, or refer the business to their captive pharmacy or provider. All benefitting the biggest insurance companies

We need to ditch the concept of "claims" and make every delivery of medications or care as a billable event that must, by law, be paid on a timely basis , with interest charges for any delays. If the physician or pharmacy doesn't deliver , the carrier has plenty of legal options already. As does the patient.

This is not an efficient market. This is the big guy abusing the little guy. It needs to change to better the care we get in this country

[Diraj Karnani @DKarnani]

@DutchRojas does reklaim health work with independent solo practices

[Diraj Karnani @DKarnani]

@InvestingDoc Gotta shoot your shot and not be afraid of a no for an answer

[Elisabeth Potter MD @EPotterMD]

I stepped out of a new patient’s consult to have this peer to peer call at the only time offered to me. You may remember an insurance company recently insisting that they’d never interrupt patient care for insurance matters. Reality Check…it happens all the time.

The doctor I spoke with was a general surgeon who had never performed breast reconstruction. He declined to give me his name, citing concerns for his personal safety. He was polite, but ultimately told me that United considers nerve sparing mastectomies “experimental”. He would not provide a written rationale or references for the studies used to make this determination.

But he kindly invited me to appeal.

Sure. What a great idea. The patient and I have all the time in the world. Let’s do this all over again.

Until we are seen and heard.

[Diraj Karnani @DKarnani]

@AskPerplexity What percent of china’s gdp does US exports make up

[Mark Cuban @mcuban]

Want to know one of the biggest problems in healthcare? Deductibles.

Deductibles are defined by the plans the insurance companies design. Then they are approved to be offered by the feds or employers. Then we the people decide what deductible we want when we choose our plans.

Often we choose higher deductibles because we are healthy or because we can only afford the lowest premium plan.

When we got get care and can't pay our deductible for whatever reason, you know who takes all the credit risk and losses?
Doctors, hospitals and caregivers

They have ZERO to do with designing, selling or choosing the plans.

But when you can't pay, they are the ones that become the bill collectors we hate. The ones that put millions into default and bankruptcy,
DESPITE HAVING NO SAY in the plans and deductibles we all choose.

That is one fucked up system that needs to be redesigned.

Next time I'll tell you how insurance companies decide not to pay what they contractually owe to the hospitals and use delay tactics like denials, they know they will approve , just to earn interest on premiums.

And the hospitals aren't innocent. But I'll let them off the hook for now because they have to take anyone that walks in the doors

@BillAckman
@elonmusk
@DOGE
@RobertKennedyJr
@DrOz

[Diraj Karnani @DKarnani]

@friedberg big fan of yours on the pod. you’ve changed how I view the world over the years. Can you comment on vertical integration impact on UHC 80/20 ratios? They pay their own subsidiaries such as optum Rx and others which leads to forced patient steering and higher margins

[Roger Seheult, MD @RogerSeheult]

Math question: Which line(s) are not responsible for increasing costs in healthcare.

Hint: I took old math.

[Diraj Karnani @DKarnani]

@VivekGRamaswamy hire @ClearValue_Tax for DOGE

[Diraj Karnani @DKarnani]

@Jason Cuban talks over people and sacks was more biased than usual. Always enjoy hearing guests talk but this one was more difficult to watch to the end.

[Diraj Karnani @DKarnani]

@lupuscyclopedia Wishing you a speedy recovery

[Diraj Karnani @DKarnani]

@SamanthaJo58296 @HealthcareREguy Why what happened

[Diraj Karnani @DKarnani]

@InvestingDoc Classic UHC, using all the admin levers to their advantage

[Diraj Karnani @DKarnani]

@InvestingDoc What is CO what does it stand for