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What prevents you from saying yes? Like can you just say “gently caress it” and hit the coverage button or does that make alarms go off in every office up to the ceo?
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Aug 28, 2019 04:04
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Pulcinella posted:What prevents you from saying yes? Like can you just say “gently caress it” and hit the coverage button or does that make alarms go off in every office up to the ceo? they probably have just as many people auditing agents to make sure they deny coverage as they do agents that deny coverage.
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Aug 28, 2019 04:06
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Yeah I think it's a weird Rube-Goldberg device of bureaucracy with like one person handling accounts and like five people making sure no one is giving any support to the insured customer and a whole lot of middle management above them trying to justify their paychecks to the people above them by getting as much blood as they can from the stones below them.
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Aug 28, 2019 04:10
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Screaming Idiot posted:Bear in mind, our systems are borked so at least twenty-five percent of the referrals that get sent to us disappear or get held up as "needing more information" for Very Important Reasons. I loving knew this was going on every time a fax from my doctor (that had a fax receipt come back, and once that the admin lady at the office called and confirmed they got even) mysteriously disappeared without a trace. It's gotta be intentional. Oh also the rest of your post is horrifying dystopic nightmare fuel and I hope you can get the hell out of there as soon as possible etc etc but god dammit fuk u prior auth forms!!! 
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Aug 28, 2019 04:29
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Pulcinella posted:What prevents you from saying yes? Like can you just say “gently caress it” and hit the coverage button or does that make alarms go off in every office up to the ceo? My job is literally to tell people "no." I have no control over the coverage, I cannot approve or deny, all I can do is perhaps change a provider on a referral to one of the accepted network providers and explain benefits. I used to assign doctors, but one of the people I talked to got upset when I asked her her name and the name of the child she called about, and she complained and I got demoted because she thought I was trying to scam her, and the company threw me under the bus.
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Aug 28, 2019 04:34
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Screaming Idiot posted:My job is literally to tell people "no." I have no control over the coverage, I cannot approve or deny, all I can do is perhaps change a provider on a referral to one of the accepted network providers and explain benefits. I used to assign doctors, but one of the people I talked to got upset when I asked her her name and the name of the child she called about, and she complained and I got demoted because she thought I was trying to scam her, and the company threw me under the bus. So like, I assume you got demoted because you didn't hide the fact you (being the insurance company as a whole) were trying to scam her well enough?
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Aug 28, 2019 04:36
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Shame Boy posted:I loving knew this was going on every time a fax from my doctor (that had a fax receipt come back, and once that the admin lady at the office called and confirmed they got even) mysteriously disappeared without a trace. It's gotta be intentional. It is. It absolutely is intentional. Insurance is a scam.
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Aug 28, 2019 04:37
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chaleski posted:Do they ever just go above you though? I've known shift leads and store level managers that still walk on eggshells around lovely customers because some petty dickhead who can't take a loss will go right to district/regional/corporate and give them an earful, which naturally makes poo poo roll downhill. corporate has the same policy believe it or not. you bend over backwards for customers until they do poo poo like not pay.
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Aug 28, 2019 04:38
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Also the only time I ever hear about customer feedback being listened to it's always in relation to punishing employees. Like in every other case, hell even if it's positive feedback, it just disappears into the void of meaningless ~aggregate metrics~ that at most get condensed into a powerpoint deck and shown to investors, but if there's a chance to gently caress over some non-management employee you fuckin' bet we're going to listen to your crazy screaming entitled feedback!!! What's that ma'am, you're saying the man who took your order is a gang stalker who drained your aura and wouldn't stop reading your thoughts? Well rest assured that we here at Yum! Brands have a zero tolerance policy when it comes to psychic vampirism!
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Aug 28, 2019 04:44
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MageMage posted:Wait, you did care coordination for trans people and you still couldn't get your grs covered??? WTF is this horseshit It's a medical reason, not an access one. I know quite well the process to getting stuff covered. It's why I know I can't get it. :V pro tip: big goon bods are soft, warm, and grow excellent titties, but risky to do surgery on e: Also faxes loving suck and were a big part of why it's so slow to get trans health cover approval, with the other being the aforementioned bullshit nature of insurance in the USA T-man has issued a correction as of 04:53 on Aug 28, 2019 |
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Aug 28, 2019 04:49
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I told some customer I delivered to like, look, I know I've already told you not to order deliveries to this dark creepy lot. Especially stop doing it after dark. Its against our company policy. They basically didnt understand at all what I was saying, apparently 'we dont deliver to any non-residential address' isnt clear. But the guy called back the next morning and said I made his girlfriend cry by saying that which is frankly the funniest thing I've heard in a while.
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Aug 28, 2019 05:09
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It's funny how introducing the profit motive to a system causes actors to act in such a way as to extract the maximum profit possible!  Not aimed at anyone here, it just boggles my mind how the US (and others too, but only the US has Mammon Worship as it's state religion) considers that fact and then says "hmm yes, we should make healthcare/schooling/infrastructure/the post office/telecom a for-profit enterprise"
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Aug 28, 2019 05:11
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Christ, now I can't stop thinking of that lady with cancer. She wasn't crying or begging. She wasn't yelling. She was angry, and she was direct, and she was right. My company and others like it are denying her the care she needs to live and die with dignity. And I am the tip of its spear, benefiting from the suffering of their victims. I can't take this much longer. There aren't any other jobs in this lovely little town that aren't the same ghoulish fastfood treadmill that I swore I'd take my own life over going back to, but if I have to give another death sentence I don't know what I'll do. I'm calling in sick tomorrow. I'm going to call anyone I can to talk this over with. I need something to take away this guilt.
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Aug 28, 2019 05:17
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Screaming Idiot posted:Christ, now I can't stop thinking of that lady with cancer. Being forced to be an abuser also makes you a victim.
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Aug 28, 2019 05:20
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you need to find a big city i guess i'd rather be a barista in seattle than a bougie cubicle dweller with a mcmansion in a suburb
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Aug 28, 2019 05:21
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got any sevens posted:you need to find a big city i guess cool i'll just move there with all the money i don't have and get support from the all the outreach programs that don't exist and drive there with the car i can't afford
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Aug 28, 2019 05:23
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We really need to set up a mutual aid society. Even letting someone sleep on a couch rent free for a month or two can really change someone's life.
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Aug 28, 2019 05:29
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Aug 28, 2019 05:43
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Siljmonster posted:what the gently caress I see you're not a capitalist. 
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Aug 28, 2019 07:10
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Ardent Communist posted:We really need to set up a mutual aid society. Even letting someone sleep on a couch rent free for a month or two can really change someone's life. Yeah I've gotten way serious about helping friends (and friends of friends etc.) by letting them crash at my place or just flat-out giving them money cuz I'm a privileged gently caress with a good job and for some reason they're all capable of being productive happy members of society that can support themselves and don't keep coming back to me for more support after I help them out of whatever hole they'd fallen in. Funny how that works.
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Aug 28, 2019 08:50
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spankmeister posted:I see you're not a capitalist. Communist 
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Aug 28, 2019 09:21
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Mechafunkzilla posted:No chance in hell Johnson & Johnson pays more than a fraction of that amount, if it doesn't just get reversed on appeal. they can also spend $500 million in legal fees which are deductible as operational costs to ensure they don't have to pay $572 million. the FDA/DOJ cannot spend $500 million to collect $572 million. it's the same thing with the $5 billion fine facebook got - they maybe spend half a billion in legal costs to fight it, and the SEC will have to stop pursuing enforcement.
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Aug 28, 2019 10:20
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Weatherman posted:It's funny how introducing the profit motive to a system causes actors to act in such a way as to extract the maximum profit possible! The really funny thing is that a post office or public telco can actually be a for-profit, or at least profitable enterprise, because as it turns out having a hundred years of established infrastructure goes a long way. The post office in Canada is a for-profit, albeit a Crown, corporation. The problem with running things for profit is that there are no rules where the money goes so the profits get raided instead of reinvested. I don't think Canada Post has gone into the red in ages, but there are definitely less profitable and more profitable years, and having number go down would be unacceptable if it weren't a Crown corp.
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Aug 28, 2019 12:25
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usually the point in the first place with public infrastructure like the post office is that it's not supposed to make a profit and often is supposed to operate at a loss as a subsidy to business so people criticizing them for operating at a loss or not making a profit are usually dumb as gently caress or just want to extract economic rents from privatizing the infrastructure
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Aug 28, 2019 13:01
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Shame Boy posted:Also the only time I ever hear about customer feedback being listened to it's always in relation to punishing employees. Like in every other case, hell even if it's positive feedback, it just disappears into the void of meaningless ~aggregate metrics~ that at most get condensed into a powerpoint deck and shown to investors, but if there's a chance to gently caress over some non-management employee you fuckin' bet we're going to listen to your crazy screaming entitled feedback!!! Used to work in an environment where this was like 99% of my communication with the bosses. “Client XYZ said you told him the rules and he didn’t like that, next time do and say the exact same thing but make sure they react well to being told bad news.” Regular team meetings about how we all sucked and were the reason anything ever went wrong. Meanwhile higher-ups would routinely gently caress up in front of the client and make them furious, but that was just Business, and those higher ups have a hard job, and should get 20% raises and all their meals and ride shares to and from work paid for. They eventually got fired by the client, but not before running through like 30 workers for a 12-person team in a year.
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Aug 28, 2019 13:43
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my wife used to work in health insurance enrollment pre-aca and had to tell people their "preexisting" conditions weren't covered (iirc, it was a dozen years ago) and it drove her to her only bout with suicidal ideation and she went on fmla for her migraines that came on once or twice per week from the stress she quit that job without another to go to because she was going to self harm if she stayed. she is now working her dream job actually helping people and is a giant proponent of m4a/single payer, unsurprisingly. when people hand wring about m4a causing insurance workers to lose their jobs a) we still need administrators and b) the only people working in insurance that like their jobs are people are execs who should be in line for madame guillotine and psychopaths who get off on knowing they're killing people over the phone
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Aug 28, 2019 20:35
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autism ZX spectrum posted:The really funny thing is that a post office or public telco can actually be a for-profit, or at least profitable enterprise, because as it turns out having a hundred years of established infrastructure goes a long way. The post office in Canada is a for-profit, albeit a Crown, corporation. The problem with running things for profit is that there are no rules where the money goes so the profits get raided instead of reinvested. I don't think Canada Post has gone into the red in ages, but there are definitely less profitable and more profitable years, and having number go down would be unacceptable if it weren't a Crown corp. Actually, Canada Post did post a year in the red, so they justified it as an excuse to gently caress up union negotiations (the Posties have one of the most radical unions in the country). The union suggested a postal bank, since there are small towns with no banks that still have a postal office, but that was ignored. The reason they went into the red? The new CEO bought a whole bunch of auto-sorting machines, so there was a big capital outlay that year and they didn't need as many workers, since now the machines could sort. Of course, the new CEO used to work for the company that made all the sorting machines, but that's probably not a conflict of interest.
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Aug 28, 2019 20:55
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Ardent Communist posted:Actually, Canada Post did post a year in the red, so they justified it as an excuse to gently caress up union negotiations (the Posties have one of the most radical unions in the country). The union suggested a postal bank, since there are small towns with no banks that still have a postal office, but that was ignored. Is this still the same guy that was hired by the previous Conservative government, who was also trying to privatize the Royal Mail in the UK?
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Aug 28, 2019 21:43
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Screaming Idiot posted:I work for an insurance company -- or rather, the contractor to a contractor to a contractor of an insurance company -- and they literally sent a company-wide email threatening to fire anybody who suggests to our customers to contact their doctors to send in a referral for treatment they already had. Bear in mind, our systems are borked so at least twenty-five percent of the referrals that get sent to us disappear or get held up as "needing more information" for Very Important Reasons. gently caress 
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Aug 28, 2019 21:53
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frogge posted:Yeah I think it's a weird Rube-Goldberg device of bureaucracy with like one person handling accounts and like five people making sure no one is giving any support to the insured customer and a whole lot of middle management above them trying to justify their paychecks to the people above them by getting as much blood as they can from the stones below them. Wouldn’t it be crazy if we instead of paying 5 levels of corporate beauracrats we used that money to pay doctors and nurses to do healthcare?
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Aug 28, 2019 23:16
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The Nastier Nate posted:Wouldn’t it be crazy if we instead of paying 5 levels of corporate beauracrats we used that money to pay doctors and nurses to do healthcare? death panels by doctors is antiamerican. only businessmen can decide life or death.
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Aug 29, 2019 02:13
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The Nastier Nate posted:Wouldn’t it be crazy if we instead of paying 5 levels of corporate beauracrats we used that money to pay doctors and nurses to do healthcare? socialism isn't going to pay doctors they're going to be forced to work, remember?
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Aug 29, 2019 02:16
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The Nastier Nate posted:Wouldn’t it be crazy if we instead of paying 5 levels of corporate beauracrats we used that money to pay doctors and nurses to do healthcare? but then how will the corporate beauracrats steal most of the money? you really haven't thought this through
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Aug 29, 2019 02:17
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The Nastier Nate posted:Wouldn’t it be crazy if we instead of paying 5 levels of corporate beauracrats we used that money to pay doctors and nurses to do healthcare? My company often waits so long to pay out claims that the provider sends it to collections, prompting my company to literally take months. Meanwhile the patient's credit gets permanently turbofucked and they're harassed by overworked and underpaid Indians in hellhole call-centers who sometimes literally scream at them to pay the bill. On the plus side, the CEO is getting a huge bonus and all those federal charges are in the past, baby!
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Aug 29, 2019 03:08
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mojo1701a posted:Is this still the same guy that was hired by the previous Conservative government, who was also trying to privatize the Royal Mail in the UK? I just looked it up and it looks like he was replaced on April 2nd by an interim CEO, Jessica McDonald, and finally March of this year by a guy called Doug Ettinger. Guy looks like a long time CEO for a dairy company, canadian chocolate company, executive for Coca-Cola, Nestle....looks like an rear end in a top hat. EDIT: But yeah, the guy I'm talking about who bought the sorting machines from the company he used to work at was appointed by Harper. Apparently there was a woman who went over the UK to privatise their mail before him. Ardent Communist has issued a correction as of 05:56 on Aug 29, 2019 |
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Aug 29, 2019 05:50
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Tashilicious posted:death panels by doctors is antiamerican. I always found it I mean, isn't that just exactly how it is in the US now?
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Aug 29, 2019 06:37
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Megillah Gorilla posted:I always found it Yeah but that’s market forces making economic decisions based on rationality. Let the government do it and all the sudden you have bureaucrats making economic decisions based on politics. I think it’s pretty clear why option 2 is worse. (Bureaucrats)
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Aug 29, 2019 06:54
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My death panel is the hospital deciding the extra couple of months this million quid treatment buys me would be better spent benefiting thousands of other patients. Your death panel is the insurance CEO upset his yacht isn't the biggest.
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Aug 29, 2019 11:33
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cakesmith handyman posted:My death panel is the hospital deciding the extra couple of months this million quid treatment buys me would be better spent benefiting thousands of other patients. Your death panel is the insurance CEO upset his yacht isn't the biggest. they'll be your CEO too, soon
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Aug 29, 2019 11:53
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Megillah Gorilla posted:I always found it Nobody actually finds this out until they're about to die and by then it's too late to not vote republican.
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Aug 29, 2019 14:47
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