• Bahnd Rollard
    link
    fedilink
    13
    edit-2
    21 days ago

    Ideally it should be 0% (this is too optomistic, but I am not one make that figure) people pay into an insurance system to distribute risk. If a company cant resolve the inflow/outflow problem (not even going to get into profits, for-profit insurance is unethical) then it needs to be managed by an organization that can. ~30 governments (USA not amongst them) that have solved this problem for their citizens and anyone requiring medical assistance within their borders.

        • bizarroland
          link
          fedilink
          1021 days ago

          Especially when you consider that these claims are not being made by random people but by trained board certified physicians whose entire livelihood depends on them providing prompt and appropriate care for their patients.

          I feel like even 16% being rejected is very high

          • @finitebanjo@lemmy.world
            link
            fedilink
            -920 days ago

            Well, the claims are reviewed by physicians but they’re often not in the specialization of the care provided so they can make mistaken judgements and a great way to appeal it is to ask the insurance company for proof that the physician who denied the claim does specialize in the type of care being reviewed.

            Unfortunately most people don’t know that, less than 1% of denied claims are appealed.