Back in January, my mother was transferred from an emergency room to an out-of-network hospital (facility) for emergency medical treatment to remove a tumor that was found in her brain. This tumor was causing her brain to swell. The emergency room attempted to call two in-network facilities first, both of which either failed to respond or did not have an open bed to take my mother.
The bill for my mother's stay amounts to nearly $400,000. United Healthcare has denied this claim in its entirety. My father does not know what to do; he is beside himself at the thought of being $400,000 in the hole. I have helped him appeal this decision twice, but they have rejected both appeals, with the most recent rejection being within the last week.
I have spent hours looking - calling, emailing, filling out online forms - for an attorney who takes on these types of cases. I have had no luck. No one I am finding seems to specialize in this area of law.
This case would be located in Tennessee (as this is the location of the out-of-network facility and the state which my father's health insurance plan is taken out of). Does anyone have any suggestions on what to do next, as well as the names of any law offices that would take on such a case?
As an aside, I (somewhat) understand the No Surprises Act, Balance Billing, and Surprise Billing. My father has not received a bill from the out-of-network facility - but I assume it is coming. I want to be prepared.
Any help would be appreciated. I keep hitting a wall, trying to get this bill figured out, but I have had no luck.
Long post ahead, TLDR I don’t feel fulfilled being a doctor anymore.
Hi, I am doctor in a specialty that is considered to be less stressful and with “good work-life balance” compared to others. Let me start off by saying that I am very fortunate for the opportunity to have pursued this career and that I did initially have the passion and drive. I took two gap years before starting school to make sure that this is truly what I wanted and even repeated one year of school because I was held back. I worked hard, made it to graduated, passed all my board exams and was fortunate to match into my dream specialty. I truly was driven and thought that this was my dream career helping people. I am sharing my own experiences and that this is not a reflection of the entire field of medicine.
I have been working about two years after completing all my training and I am coming to the realization that this career is just not for me. It is not that I don’t like helping patients (except for the trouble patients, but that is a story for another time), I am just tired of insurance and businesses (which are, by the way, ran by people with no medical degrees) dictating what doctors can do for patients and which services are covered for the patients. Angry patients then take out their anger on providers who have no control over what insurances or hospital/clinic policies. I genuinely just wanted to help patients feel better, but the way that our healthcare system is makes it very challenging.
My job pays decently (pay ranges 100-150K, maybe 200k if I were to live in a remote area), but it is nowhere near what other medical specialties pay for the same amount of work. I still stay late seeing emergency patients, charting, and I am sometimes asked to work on weekends. I feel like I have lost so much of my 20s from school/residency and I resent that even as a doctor I still do not have weekends to enjoy with my family and friends. I am not sure that the amount of stress and the pay are worth it.
After a very bad experience at my last job, I decided to quit my full time job. My boss did not pay me my commission for nearly a year, wrongfully wrote on my offer letter that I had paid sick days (and did not honor them when he realized it was a mistake even though we both had signed it several months ago) and made numerous inappropriate remarks while we worked together. I am currently looking for part time positions to hold me over while I figure out my next step, but it has been very challenging to find a position that does not involve a difficult boss or a crazy work schedule. I am actively trying to leave it all behind and transition into something else.
I see my colleagues working hard and not complaining at all, so sometimes I wonder if I am just the odd one out. Just had to get this out of my chest, thanks for reading and making it this far.
A month and a half ago I fell from a tree and broke my neck and sternum. I had three vertebre fused and a week long hospital stay. I've accrued about $150k in medical debt. I'm a single person. I work in trades. I'm training to do some not so physical labor at the moment and have a great job that is continuing to pay me through my recovery. I'm not sure what I can do about this debt though. So far I've been told I'm sol. I have another meeting with the financial office tomorrow. How is this going to impact my credit? Are there any resources I'm missing to help cover these expenses? Thanks for the help yall.
Curious!
Hey yall, I'm currently trying to become a radiology tech and because an associates degree is required, which field do you think I should get it in? Just looking to get a broader understanding of the topic & learn some relevant things
I have been experiencing years of pain and ineffective treatment; I was finally directed to Dr. Nicola Longo, the clinical chair of genetics at UCLA. He said I need to have a sleep deprived EEG and a nueropsych evaluation done before meeting him. I had trouble to schedule an appointment within UCLA’s system; therefore, I switched to Cedars - Sinai. I was scheduled with this psychologist without experience. I called in everyday, and rescheduled to a different psychologist. Upon check, I found he doesn’t have experience either. I called in again, asking if I can switch to an experienced doctor; the experienced doctor does not have earlier availability before my genetics appointment. I scheduled with the experienced doctor and was confirmed that earlier cancellations happen on a frequent basis. Two weeks prior to my genetics appointment, I contacted Cedars-Sinai again, learning that I have a 20th spot on the waitlist. I contacted patient relations department; I said I was confirmed by the front desk that an earlier spot is a possibility; I did not know I would be moved to 20th spot on the waitlist. They helped me to get a nueropsych evaluation two days after. I was put with the inexperienced psychologist with whom I originally scheduled. I was told that while she doesn’t have a lot of experience, she held the highest license in their field. Her supervisor told me that she qualifies for 100%z I thought, okay, I went to the psychological evaluation in pain; and I wasn’t able to sleep at all the night prior. Eventually, this neuropsychologist told me that she can conduct a “interview”, but she has to postpone the formal evaluation after 3 weeks, because she has a vacation.
I told her that I have a rare, time sensitive appointment, and I talked to her supervisor before due to an issue with the front desk. By the time, I didn’t know what I was talking about since I was experiencing a lot of pain. She immediately agreed to move my testing to this Tuesday. She usually does not see patients on this day.
However, after 2 hours of testing; she said that her clinical impression is that I have mild autism. She cannot officially diagnose it, but she thinks my symptoms can be “examples of neurodivergence”, because “autism people frequently have these problems”. I wrote a 10 page narrative to bring to her in my second evaluation. I also said I met four different doctors — three internists with over two decade of experiences for each of them and two neurologists who all agreed that I definitely have an advanced issue. She said she holds her clinical impression.
When I asked her of my raw testing data, she said she cannot release them to me, because only she is licensed to interpret it. She is a licensed psychologist. The clinical genetics chair of UCLA is not licensed. Since she has a 3 weeks vacation immediately, and it takes another two to three weeks to write a report. I have to wait five to six weeks for my nueropsych report, just like every patient. This is the “due process”.
She can only tell my genetics doctor that her clinical impression is “mild autism”. I asked her if it is her official diagnosis, she said, this nueropsych is too short for a diagnosis, she is not specific in the field.
She suggests me to visit UCLA’s nueropsych team. However, she will write that her clinical impression that I have mild autism. She cannot give me any raw data. I am free to talk to her boss about the issue. I just have to wait in line like every other patient for the full nueropsych report.
She also kept my 10 page personal narrative with her; after demanding these documents, she used white-outs on these documents. She reprinted the first three pages of my narrative. She claimed that her notes were not clinically salient enough. I said it is my patients right to obtain these documents and the raw data. She said it is not my right, and giving me the raw data and the notes can cause her to lose the license. I said my notes are my personal property, she said, so is her notes, they are her personal property.
I wrote to cedars Sinai’s patient relations, but my language was less calculated; now, they tell me that it takes up to 30 days to process a grievance. I checked online; cedars Sinai’s webpage shows that I visited her supervisor, another doctor with 2 decades of experience, instead of her. I found she is a doctor who just obtained her formal license around a year and a half ago. Just a year and a half ago, she was a psychological associate. What should I do?
If you missed it, the court finally approved the agreement between CareDx and $CDNA investors over hiding issues with Medicare billing rules. So, here’s a quick recap and some details.
Back in 2021, CareDx promoted growing revenue from its AlloSure test. However, later it was revealed that the company had billed Medicare for tests that didn’t meet medical necessity rules and had paid illegal incentives to doctors.
After that, the company even reported it was under investigation by the DOJ, SEC, and a state regulator, causing the stock to drop by 75%.
So, after all of this came out, investors filed a lawsuit against CareDx.
Now, after 4 years, they finally agreed to settle and pay them for their losses. And the court finally approved the agreement. So, if you got hit by this, you can check the details and file for payment.
Anyways, anyone here invested in $CDNA when this scandal happened? How much were your losses if so?
It looks like they support travel gigs, local contracts, and even help with licensing. Has anyone here actually tried it?
I work in radiology at a small clinic that was purchased by Optum / United Health last year and the changes have been rolling out slowly month by month. Today I learned that the person who wears roughly all the hats and keeps the radiology workflow moving has put her notice in because Optum refused to match $2/hr to keep her. This is on the doorstep of sweeping changes in systems coming in September. It’s nothing less than a display of wild incompetence and I’m at a loss for why anyone with a pulse can’t see the value she brings. Even for such an evil corporate entity this is short-sighted and really puts on display where the values lie. Spend a dollar to save a dime.
Yeah
I don’t understand how expensive health insurance is and continues to become. More so now with all the changes happening to plans and the ACA after 2026 starts, I just don’t get how people can survive when medical benefits are priced the way they are.
Not only are plans extremely expensive for people who don’t get any subsidies, that’s just the tip of the iceberg. Then you have the doctors visits, the prescriptions, checkups and whatever else tacks on to the bill. At a certain point I can’t keep hearing that “because medical technology gets better, the prices for premiums get higher.” At a certain point it basically becomes unlivable and unfeasible except for the wealthy who can afford to pay these prices and not bat an eye.
Then there comes the salaries of the executives and the board members of the insurers who take their kickbacks and continue to receive 7-8 figure salaries all from “overseeing and managing operations.” Not only can it be agreed that these kinds of people are grossly overpaid, but wouldn’t it make more sense to put money that these figures are being paid back into the system to improve it and make it easier for not only the patients, but also the doctors and practices that work with these insurers? Instead we STILL have insurance carrier technical discrepancies and issues like billing inaccuracy and false claims/charges when this can all be fixed or handled way better if we properly distribute the amount of money that is put into this industry sector instead of just paying these grossly overpaid salaries to people who “manage operations” and make their decisions the way they do or are told.
It just doesn’t make sense to me and I want it make sense. I’ve been telling myself every possible excuse as to why things happen the way they do and after what’s been happening societally in America, I can’t justify that I think what’s going on is fair or sensible anymore. It makes me worried that trump can say and declare all these changes that he wants to happen but that he lacks for the foresight to see what’s going to happen on the way to making that vision a reality. If we can realistically spread apart the money being made in this space, I think that’s the first step to having healthcare feel like it’s even remotely balanced compared to the chaos it is now. Thanks for listening to those who made it this far.
I am a 36 year old female living in California. About an hour ago, I received a call from my insurance company (BCBS) to schedule a general check up with a GP, with the rep reiterating that it’s a zero copay and included in my benefits (and was very pushy with getting me scheduled right then and there).
In the 10+ years I’ve had health insurance, never have I ever had an insurance company call to schedule a Dr’s appointment for a patient. For a service, which they will likely pay a non-zero dollar amount to the doctor providing the service. AND they are paying an employee to sit and make calls to insurance holders.
In our capitalism society where squeezing maximum profits is the utmost priority, and with the OBBB having been signed into law just earlier this month, I’m really suspicious of this. Does anybody have any insight as to why an insurance company might suddenly have an interest with getting patients records updated? And just to be clear, I saw a GP last year around this time, so it’s not like my health records are extremely outdated (by like 5+ years).
TIA
Recently went through something traumatic that shook me to my core and all of my bottled up, very unmedicated anxiety and depression resurfaced. In the process of being diagnosed with acute stress disorder (PTSD Lite™) and possibly a more serious underlying mood disorder, and trying to start medication ASAP. My therapist told me he recommends I have GeneSight psychotropic testing done so that I know which SSRI and anxiety meds to avoid. Turns out, GeneSight is a private company that requires the test to be ordered by a doctor, I cannot order it for myself.
First I called my primary care physician (whom I have only seen once since I had to switch doctors in May after my last one, whom I also had only seen once, left the practice). Found out his practice isn’t registered with GeneSight to order the test. Called GeneSight, spoke to a representative who told me that my PCP was registered to order the test, just at a previous practice and she would reach out on my behalf to my doctor’s office about ordering the test. Never heard back. Called around a bunch of local hospitals at the recommendation of my therapist (I am currently living on my college campus for the summer) and everyone I spoke to either had never heard of GeneSight or said they weren’t registered to order it.
Called the GeneSight lady back, she didn’t pick up. Called my doctor’s office again, the woman with whom I spoke said that it doesn’t matter if my doctor was registered to order the test at a previous practice, since he’s with Duly now and they aren’t registered he can’t order me the test.
I feel like I’m losing my fucking mind, why is it so goddamn hard to get this fucking blood test ordered so I can start on medication. At this point I don’t know if I need to consider switching doctors AGAIN or if there’s something else I can do that I just haven’t thought of yet; I’m 19 and handling all of this healthcare shit on my own is very stressful and new to me.
Hello!
I recently had a terrible experience at my primary care clinic and wanted help on how I can report her and make sure no patients have to go through with her.
I had an appointment and wanted help regarding my ADHD. She focused solely on my anxiety and I felt as if it was more than anxiety. I had made many mistakes in my life due to ADHD that ruined parts of it. Wanting to go back on ADHD meds but an alternative since I couldn’t gain weight, she refused due to me being on sertraline already. She offered me another anxiety medication but I refused, feeling like my anxiety was okay and I can control it more than my ADHD.
After feeling like I wasn’t being heard and I was just being bombarded with all these anxiety things I’ve heard before from several doctors, I told her I wasn’t being heard and I wouldn’t want her to be my PCP anymore.
She then became hostile, and shouted at me as I cried wanting more from my doctor. She told me to hold my tongue, and told me a patient shouldn’t be speaking to a doctor like that. She told me to not come running back to her if I needed help.
I ran out to get a medical assistant because I felt unsafe. The doctor stepped out and told one of the medical assistants that did not room me that I had issues, and talked to her about my medical information in front of me.
I read the notes and she said I agreed to take the medications even though I refused to. She said I created a scene, wrote down that I used abusive language. She also brought up multiple of my past issues and used that against me on my chart.
I don’t know what to do, and I felt unsafe and crazy even though I am simply asking her for help. I didn’t shout at her and I just felt unheard and unsupported.
I reported her to the DOH and the facility she’s at, but a part of me feels like I’m in the wrong somehow.
Please help or listen :/ thank you <3
edit: im also an ma that works in the medical field. hope this helps a bit
Reading more about how health insurance impacts both patients and providers has me wondering what would it actually take to improve the system?
Between administrative hurdles, cost barriers, and policy gridlock, it sometimes feels overwhelming. But rather than just venting, I'm curious what realistic steps could lead to meaningful reform.
Would it take policy shifts, public pressure, or broader changes in how healthcare is delivered and financed?
I'd really like to hear what others think especially those working in the field. What changes would make the biggest difference for patients and providers?
People who have switched their paths, how's life going on. I'm a mbbs graduate and I'm not really fond of working with patients as a clinician. So I am trying to gain knowledge about other future prospects I can consider. People who did the same- like went towards administration or in healthtech sector, how's life treating you. What are the skillsets needed for the same? Do you have any regrets? Plus how's the basic pay and lifestyle like. Would really love to know more? Any guidance would be appreciated. Thanks.
To help improve the current system.
Hi! I’m being added onto my husband’s health insurance plan as a secondary insurance for myself. I have anthem BCBS as my primary… do I need to tell them about getting a secondary coverage? SHOULD I? Wondering if anyone has done this before and if there would be any cons to this (e.g., they can choose to cover less things now or my premium goes up somehow).
I called anthem and they were less than helpful. Thanks.
Not looking for medical advice A family member (M66, Mass. USA) with history of cardiovascular issues went to the ER with chest pain thinking it was a heart attack. Doctors confirmed minor attack and told us he lost half his blood volume due to an internal bleed, and admitted him due to this. They just told us they made a mistake with their testing and he is completely fine. He already received blood transfusions that it turns out he didn’t need. We are very glad he’s ok but worried about the bill from repeat tests and unnecessary hospital stay, and concerned there will be adverse affects of the transfusions. Is there anything legally we could do?
It is clear that the widening gap between the rich and the poor isn't just about money – it has tangible, negative impacts on people's health. Increased wealth inequality can lead to reduced healthcare access, worsening rates of addiction, and increasing disease related to unhealthy environments. It feels like a vicious cycle where wealth concentration doesn't just limit opportunity, but actively undermines health for a significant portion of the population.
I am a physician in the US. Things are worsening, funds are being cut, patients are becoming increasingly reliant on emergency services, which increases the cost of healthcare and increasingly excludes the poor. This has been ongoing for a long time and the trend continues. We are now worsening this pattern with recent policy changes.
I think there's always going to be debate on which systems are better, private vs public, single payer, etc. But at the heart of it there is the direct link to wealth inequality and worsened health outcomes, regardless of system.
What are your thoughts on this? Have you seen direct examples of how wealth inequality impacts health?
Sources: I read and discuss this so often now I dont know all the data, but here are some sources.
https://pubmed.ncbi.nlm.nih.gov/28402829/
Opinion | Lawrence Summers: This Law Made Me Ashamed of My Country - The New York Times https://share.google/sQQnjwGq2SJsFq28w
0$-155$: 0%
155$-260$: 50%
260$-570$: 75%
570$-3090$: 85%
3.090$+: 100%
For every citizen. Keep in mind the median personal income US is 42k, while in Denmark it is 75k, and drug prices in us are almost 3 times expensive just on average.I thought privatization and lower taxes should stimulate business and thereby wages, and push prices down through efficient market dynamics?
Hi everyone — I help run a 6‑bed recuperative care facility in St. Paul for people transitioning out of a hospital, who have a medical need, and are experiencing homelessness or unstable housing.
We offer private rooms with a bed and a secure area for valuables, showers and bathrooms, three daily meals, daily nurse wellness checks, and on‑site support with case management.
To qualify, patients must be medically stable and able to perform basic self‑care, stable enough to not require inpatient care but too ill to recover on the streets. A referral from a hospital or clinic is required, and the patient must have active insurance coverage.
We’re happy to connect with hospitals and clinics to support patients in need. Please reach out with referrals or suggestions — we’re here to help!
I need some advice because my situation is a little complicated and I've never done any of this before. I starting yapping at the bottom, but here's a quick summary
Quick Summary
Questions
If no insurance:
I'm not making a lot of money right now. I'm not too worried about the far future because my career path is decent. I am worried about right now, because she needs pregnancy care without insurance. She cannot be added to my work insurance without a SSN (I was really hoping this wasn't the case).
Basically, what are my options here? Is there other insurance available for people in her situation? Should I just plan to be in major medical debt and maybe file bankruptcy? Should I drive her to a different state to get care or even deliver the baby, or is that a completely stupid idea? Honestly I'm lost with what to do here
I research as much as I can, I make sure she eats right, has her vitamins, gets some exercise, only takes approved medicines, etc... I know it doesn't replace getting to the doctor. I will do whatever I need to. I have to pay rent, utilities, groceries, gas to get to work... these are priorities. I don't have a ton of money left over. I have side hustles that help in varying amounts. I think I can gather extra money in the next few weeks for a visit if it's not too much. What is my best course of action? Is there things you 100% recommend she gets done and maybe nonessential things I can save money on?
I've never had a pregnant wife before. I know having a baby right now wasn't the best idea. It's her first pregnancy, and things are scary for her in general. I know it's not ideal but truly I've never wanted anything more in my life than to start a family with her, and I will do whatever I need to for them. She worries that she's not doing anything right and there is no baby... I try to reassure her and she knows anxiety is a bitch and everything is probably fine... but I know only a doctor visit will ease her mind. I want to give her some good news. I just need some guidance from people who know things PLEAZ