A friend who is the business manager for a dental practice told me this story recently. At the annual continuing education classes one year, there was a session on how to file claims and get reimbursement. The presenter was a dentist who had worked in the insurance industry. He said that the claims that were still on the desks on Fridays ended up in the garbage can so that all work was completed on time. Patients were told when they called, � ���"We have no record of your claim.� �� � This was standard operating procedure to stall legitimate claims. Patients who never followed up, of course, never received any payment, so this also saved the insurance company considerable potential payouts.
You know, I hadn't heard that. I do know that there is incredible pressure within companies to manage medical expenses. One of the ways they do that is to ratchet down on claims payments. So there absolutely are incentives to deny claims and to delay paying claims because that means there's more money available for profits.
Are you at all fearful that your actions could jeopardize your own health insurance coverage?
You know, I've thought about that. I don't think so. I now have a pretty high public profile. And I don't know that my insurance company would take that kind of action because I'd write about it, and tell about it. It could happen, you never know. Like everybody else, I hope I don't lose my insurance. But on the other hand, there have been times in the past when I've had to try to get insurance in the individual market so I know the difficulties that gives. I'm an older person now with medical history. I know it sure would be hard for me to get a medical policy in the individual market today.
Is it safe to say that you are more at peace with yourself now that you've broken with the health care industry?
Absolutely I'm more at peace with myself and I'm much more proud of what I'm doing. And when I'm talking, when I'm answering questions from reporters, I feel a freedom I never felt before because I know I'm saying things that are true and hopefully helpful and that helps me sleep a lot better at night.
That's worth a lot. Is there anything you'd like to add, Wendell?
One thing is to encourage advocates of reform to remain advocates. Right now, it's really important that people take action. The next few weeks will be critically important; they're critically important for the future of this country, some of the most important weeks that we'll have in our history. Because we are on the verge of doing something that no Congress, no president has been able to achieve, which is at least some kind of meaningful health care reform. It may not be all that we all hope it will be but we should all keep working for what is best.
But over the next few weeks, I hope that people will pick up the phone and call their members of Congress. I would call the district offices, I would call the staff people that work in the district offices rather than in Washington. I would also write letters, I'd pick up pen and piece of paper and write a letter. And I would send email and I'd encourage my friends to do that. Members of Congress need to know that there are a lot of people who expect them to do the right thing. This is necessary to counter the influence of the lobbyists. So, that's what I'd like to end on. People need to keep the faith and keep working hard.
Good luck to you, Wendell.
It's been a pleasure speaking with you. Thank you for making sure that we have the inside
scoop on health insurance industry practices at this critical juncture. You were definitely in the right place at the right time.
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Part one of my interview with Wendell
Part two of my interview with Wendell
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