Insurance companies & why they tick me off!

Specialties Cardiac

Published

I took care of a pt earlier in the week, mid 40's male with an extensive crappy history. CHF, CAD, PVD, cardiomyopathy, CVA x2, MI x4, HTN, IDDM, on and on and on. Got this pt at 7am, having BP of 200's/110's, nitro gtt doing nothing. Trop and CPK through the roof. After hours of getting orders and drips and cath lab lined up, finally get the pt's pain under control enough to actually talk to him. Found out that his insurance company had refused him several times to get a vent. pacer because he isn't "sick enough". :angryfire Are they waiting on this man to DIE before they will cover it? That's what it seemed like to me. Absolutely sad!

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Specializes in PeriOp, ICU, PICU, NICU.

I can see your frustration. Glad you got it off your chest too. Take care and good luck :)

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I took care of a pt earlier in the week, mid 40's male with an extensive crappy history. CHF, CAD, PVD, cardiomyopathy, CVA x2, MI x4, HTN, IDDM, on and on and on. Got this pt at 7am, having BP of 200's/110's, nitro gtt doing nothing. Trop and CPK through the roof. After hours of getting orders and drips and cath lab lined up, finally get the pt's pain under control enough to actually talk to him. Found out that his insurance company had refused him several times to get a vent. pacer because he isn't "sick enough". :angryfire Are they waiting on this man to DIE before they will cover it? That's what it seemed like to me. Absolutely sad!

You don't understand the purpose of insurance. You see, it's first obligation is to it's shareholders. They have to give them a return on their investment. Now how can they do that, if they meet every demand of a policy holder? They are actually short sighted, denying what would actually save them, in the long run.

Grannynurse :balloons:

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I hear you....I am enjoying the ER right now so much because I don't have to deal with insurance companies. From a cardiac rehab standpoint, some private pay companies didn't think it was enough that you had triple bypass surgery to qualify you for cardiac rehab...no sirreee, you had to have a CABG, an EF

Odds are no one has gone to bat for this guy i.e. sat on the phone for hours until reaching the medical director.

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