“Medical cost containment costs” funnel monies which might compensate physicians and other providers for work they do in the hands of interlopers, middlemen, scan brokers, and other drains on the system as they seek the lowest bidders in a race to the bottom of quality. Bill review blocks payment of legitimate charges, and/or makes it very costly to get paid. Utilization Review blocks appropriate care, and/or makes it very costly to arrange. “Case Managers” interfere with the process in ways the claims administrator are forbidden, at great expense, despite being nonexistent in Labor Code.
The hidden but more important cost, in my view, is the alienation of providers, especially specialists and consultants. Most specialties are completely absent from the system, in no small part because they can’t afford to get paid and they can’t provide care timely and reliably without a fight every step of the way. And they won’t have hired guns (Case Managers) interfere. I predict only the corporate and largely mercenary providers will soon see our injured workers.
“Medical cost containment costs” funnel monies which might compensate physicians and other providers for work they do in the hands of interlopers, middlemen, scan brokers, and other drains on the system as they seek the lowest bidders in a race to the bottom of quality. Bill review blocks payment of legitimate charges, and/or makes it very costly to get paid. Utilization Review blocks appropriate care, and/or makes it very costly to arrange. “Case Managers” interfere with the process in ways the claims administrator are forbidden, at great expense, despite being nonexistent in Labor Code.
The hidden but more important cost, in my view, is the alienation of providers, especially specialists and consultants. Most specialties are completely absent from the system, in no small part because they can’t afford to get paid and they can’t provide care timely and reliably without a fight every step of the way. And they won’t have hired guns (Case Managers) interfere. I predict only the corporate and largely mercenary providers will soon see our injured workers.
But Medical Costs are down.