I Was One of Those Companies
Her question was how many companies get paid before a patient gets care. I was one of them.
Why Eight Patients Can End Up in Federal Court
Five hospitals, one insurer, eight patients, and AI now being added to both sides of the fight.
Nobody Made Anyone Substantiate the “Yes”
Payers should have to prove their denials. The same question cuts the other way, too.
Immaculate, and False
Clean-looking records are not evidence that a payment was accurate.
Whoever Feeds the Adjuster Controls What It Finds
A payment model that pays on a description instead of an examination gets better descriptions, not better care.
My Cheapest Accomplice Was Two Words: “Industry Standard”
I didn't need a consultant to milk fee-for-service. Two words did the job: “industry standard.”