The Cost of Insurance Denials

belk David Belk, M.D.

Hello everyone. Once again, it’s time for another case study on how our health care industry is robbing us blind.

You might remember that a few months ago I wrote a blog about a breast cancer patient whose health insurance company refused to pay for one of her chemotherapy medications. Because her insurance denied coverage, she was forced to pay three times the cost of that medication (over $60,000).

My latest blog is similar to the last one I wrote, in that it deals with the cost of health insurance denials. This time, it’s about a patient of mine who got some routine blood tests. His insurance denied coverage for the tests because they didn’t like the reason I gave for ordering them. As a result, he received a bill from the lab for six times the cost of the tests. He was fined several hundred dollars for my mistake (I fixed the problem, so he didn’t end up paying).

This blog expands on what I wrote in my last blog, in that it details the ways in which health insurance companies will arbitrarily deny coverage to inflate our out of pocket costs. This arrangement not only increases total health care costs in the US, it creates a serious conflict of interest for health care providers. Any time your medical service is denied by your insurance after the fact, the provider of that service ends up getting a huge bonus because they can collect the full billing charge from you.

So insurance denials have nothing to do with cutting health care costs. In fact, they increase these costs considerably.

Dave Belk MD