Hmo Denial Care

1602 Words7 Pages
Denial care is one of the tools insurance companies use to refuse vital care to millions of patients in the United States who need immediate medical attention. Some lose their lives in pursuing the proper care leaving families and friends with nothing to hold on to. However, because of insurance companies denial care other families will soon go bankrupt. Families file bankruptcy to enable them to pay for the treatments they need. The life time limit is the amount of money health service providers are willing and able to pay in a life time of the patients; this is one of the basic tools of denial care. However, the effect of health care denial, the legality, whether it can be thought by institution of insurance companies, why the government…show more content…
According to research from the ebsco host website doctors are also compensated for denying a patient care that is necessary for treatment. Many fear that HMOs reverse the incentive by rewarding physicians for denying care. Some plans create a very powerful incentive for doctors. The doctor limits patient access to services by withholding a significant percentage of payments until after an assessment of the doctor's performance. Speaking of HMO, from research it is one of the organizations that encourage denial care. The core principle of HMO is to limit cost for the patients. However, according to the leopald law, “HMO have internal policies and procedure that gives direct cash bonuses and other financial incentives to claims reviewer who deny claim or limit hospital admissions and stays regardless of medical necessity. Leopold also states that humana instituted programs deny patients access to hospitals and bonus incentives are awarded to the case manager, nurses, and physicians. In order to earn more money, HMOs use money to persuade doctors to deny necessary care to patients. Patients are the victim in this scenario. The government is not regulating insurance companies from exploiting the innocent. Manage care cater for terminally ill patient. Instead of increasing staff for the patient to receive adequate care , they use the same…show more content…
How according to ()"A competing bill is being drafted by the Medical Society of the State of New York (MSSNY). They would limit medical necessity to only generally accepted standards of care. FAIM argues that the quality of care expected from New York doctors (as enforced by malpractice liability standards) is far more demanding than just "generally accepted standards," and that MSSNY's proposal would let insurers off the hook not only from liability but from coverage as well. MSSNY replies that they just do what the AMA tells them to do”. Well this law again that only accepts payment of medically necessary treatment from patients. This is appalling because the insurance company will define treatment that is medically necessary. Like my case I had the insurance card and I could not pay a doctor visit because I never knew which standard deem necessary by the insurance company for an emergency room visit. Example if one need a treatment and it is not consider a standard care the insurance company deny the care and save money. I realize that besides the government, insurance companies write their laws in the United States and get away with anything they want

More about Hmo Denial Care

Open Document