Maybe a hospital CEO that self-insures, can explain this to me.
For your medical benefits, for your hospital employees, why would you hire an ASO that requires a Pre Authorization, and then issues denials for the care that YOUR DOCTORS, the ones that work for you, recommend for your employees and their families ?
In other words, even though you are paying for the care, that your doctors recommend for your employees, the benefits administer that you hired , is saying. It to trust your doctors.
Do you not trust your doctors ? Or do you trust the ASO, probably owned by a big insurance company, to dictate care for your members, over your doctors ?
I just don’t understand why the CEO doesn’t just say, “trust our doctors”.
And one more question , do even know which life threatening episodes your employees or their family members have had denied ? Shouldn’t you want to know the severity and what it would take for them to get the care your docs require ?
Anyone got any feedback on this ?
If insurance companies can deny care and call it "medically unnecessary", why aren't they required to have malpractice insurance doe when they get it wrong and someone gets sicker or tragically dies ?
@KirkHerbstreit It’s great when the players and coaches want to be there! When they don’t, it’s just an exhibition game with an increased opportunity for injury. At the end of the year every team should assess where their team is and decide whether to accept an invitation.
So folks at @espn are upset ND isn’t playing in a bowl game after weeks of folks politicking against the lack of conference affiliation, using them as a pawn for their CFB playoff selection show, having the ACC network play the UM/ND game on repeat for 48 hours during Conf Champ week BUT now it’s a bad look they don’t want to serve ESPN’s best interest by playing in an exhibition bowl game? Got it.
Julian Love, a Notre Dame alum, seems to be collecting on a friendly agreement made between him and the USC alumni on the team. Thus the “big ass leprechauns” strolling thru VMAC.
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What a joke. When your state puts the Big PBMs above their local pharmacies they are telling you they don’t care about the health of their residents.
The big question is: What value do the big PBMs actually offer ? The state doesn’t need them to negotiate prices or determine their formulary. Nor do big companies.
If you want a PBM, require a pass through PBM that publishes their actual net cost per claim and works on a net cost, transparent basis