7/22/2007

Tell Us Again, Dr. Gupta, Why You Had To Criticize Michael Moore?:
Here's everything you need to know about what it means to have private insurance. On, ironically enough, CNN's House Call With Dr. Sanjay Gupta this weekend, guest host Elizabeth Cohen talked with patient advocate Nancy Davenport-Ennis and answered viewer/victim e-mails. Here's Davenport-Ennis's response to a question about what a patient needed to do after being denied coverage for a gallbladder operation because, the insurer claimed, of a pre-existing condition:

"In the case of Loretta, there are three or four concrete steps that she needs to take. Number one, she needs to get a copy of her health plan. Number two, she needs to ask the hospital for a copy of the medical records that were provided to the insurance company upon which they made the decision there was a pre-existing condition. She needs to go back to her files at home. And if she has a copy of her original application for health insurance, she needs to refer to that. If not, call the health plan. Ask for a copy of her application and ask for a copy of the health form that she filled out at the time she applied.

"If in reviewing all of these forms she finds that there is no mention and no evidence of a pre-existing condition, she's ready to sit down and draft her letter appealing this decision. And again, we encourage her to have her doctor support her in this process and write a letter of his own identifying the medical necessity for this care, and as her treating physician, indeed, he did not have any evidence that this was a pre-existing condition."

Sweet merciful fuck.

Be sure to read earlier in the transcript for the case of a couple at an in-network hospital whose newborn preemie had to go into the NICU at the hospital, but was treated by out-of-network doctors. It's $150,000 worth of larfs.