Health ReformPolicy & Law

Insurance Coverage Denials: Private versus Public

1 Mins read

The people behind the coming denials: The people behind the coming denials:

[Centers for Medicare and Medicaid Services] has fewer than twenty physicians on its coverage staff and fewer than forty total clinicians once pharmacists, nurses, and other health care providers are counted. While this isn’t a precise surrogate for sound decision-making, it gives insight into how well the agency informs its decisions. Most of its physicians are generalists. It doesn’t have a single oncologist on its staff, and has just one nephrologist despite the fact that it pays for the vast majority of dialysis performed in the U.S. To give a basis for comparison, private health plans—which exercise far fewer authorities to set prices or coverage rules—have more clinicians by order of magnitude on their staffs. Aetna has more than 140 physicians and about 3,300 nurses, pharmacists and other clinicians. Wellpoint has 4,000 clinicians across its different businesses, including 125 doctors and 3,180 nurses. United Healthcare employs about 600 doctors and 12,000 clinicians across its health care business.

Related posts
Medical EducationPolicy & Law

Why Refinancing Medical School Lending Makes Sense

2 Mins read
Once you graduate from medical school you probably assume your financial situation will improve dramatically. While it is true that you will…
Policy & Law

Here’s What You Need to Know About Post-Accident Action Items

3 Mins read
Comedians and entertainers love to poke fun at lawyers, especially those who specialize in car accidents or other personal injury claims. But…
Medical EthicsPolicy & Law

5 Steps to Starting a Medical Malpractice Suit

2 Mins read
If you have been a victim of medical malpractice, it may seem overwhelming to even contemplate bringing forth a medical malpractice suit….