The moral of this
biblical proverb is in its advice to attend to one's own defects rather than
criticizing defects in others. Its
relevance and practical applications are virtually without limit, for it can
even be referenced in any situation or circumstance wherein an entity (whether
corporate, individual, or other) bemoans the unfair treatment it feels it is
receiving, but where that entity's inaction or misguided effort enables the
perpetuation of such mistreatment despite the availability of assistance that
could affect a positive change.
What does this have
to do with medical providers and facilities?
Plenty.
While the
outworking of the Affordable
Care Act continues, for better or worse, to define the economic impact to
one-sixth of the U.S. economy - an impact which in a free enterprise
system is felt on every level of a medical
provider's ability to thrive and thus continue to offer the highest quality
of care - the interposition of healthcare insurers in the doctor/patient
relationship remains powerfully influential in determining what that
quality of care will ultimately be.
Physician practices, like hospitals, are after all "for-profit"
entities, and are largely dependent on receiving fair payment for the vital
treatments they render. That payment
must pass through a for-profit
insurer. And therein lies a problem,
both potentially and practically, if not inherently.
Even a cursory
review of websites devoted to the bad faith payment practices of medical insurers can
leave one's head spinning. The means
utilized to achieve their end (which is quite simply, to increase their profits)
are often the results of far more time, thought, and investment than the
medical arena as a whole seems able to match.
Whether by implementing evermore obstructionist appeals processes,
defaulting to payment schedules developed within the insurance community
itself, or adopting computerized payment systems whose very appeal to the
insurer is the cost savings promised by that system's sales representative, the
insurer has come to occupy the coveted high ground on the battlefield of
reimbursement to medical providers. Thus,
they are winning that battle. What's a doctor, hospital, or
surgery center to do?
First, know that it
doesn't have to be this way. There are
very powerful remedies available to the victims of insurer
denial and short-pay practices.
Next, get connected with a law firm that cares enough to fight hard for
the fullest extent of your rights and has done so with consistent effectiveness
and with integrity. Be very circumspect
in your choice of that advocate, for there are many and their track records are
as varied as their cultures and business models. But regardless of whether or you choose to
take these steps, consider this: Callagy Law has recovered
over $140,000,000 in additional payments for our healthcare clients and medical
providers, including over 30,000 settlements and awards in the past five years
alone.
This is a huge, and
hugely significant, battle. Fighting it
alone is like taking on the Red Army with a BB gun. Ultimately, you will get the representation
and results that you insist on for yourself.
Just know that we are here to help you as well. Contact
us, and let the healing begin.
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