I agree, and I can see where it comes from (at least at the state level).
The cycle is: bad trend happens that has deep root causes (let's say PE buying rural hospitals because of reduced Medicaid/Medicare reimbursements); legislators (rightfully) say "this shouldn't happen", but don't have the ability to address the deep root causes so they simply regulate healthcare M&As – now you have a bandaid on a problem that's going to pop up elsewhere.
I mean even in the simple stuff like denying payment for healthcare that should have been covered. CMS will come by and out a handful of cases, out of millions, every few years.
So obviously the company that prioritizes accuracy of coverage decisions by spending money on extra labor to audit itself is wasting money. Which means insureds have to waste more time getting the payment for healthcare they need.
I agree, and I can see where it comes from (at least at the state level). The cycle is: bad trend happens that has deep root causes (let's say PE buying rural hospitals because of reduced Medicaid/Medicare reimbursements); legislators (rightfully) say "this shouldn't happen", but don't have the ability to address the deep root causes so they simply regulate healthcare M&As – now you have a bandaid on a problem that's going to pop up elsewhere.
I mean even in the simple stuff like denying payment for healthcare that should have been covered. CMS will come by and out a handful of cases, out of millions, every few years.
So obviously the company that prioritizes accuracy of coverage decisions by spending money on extra labor to audit itself is wasting money. Which means insureds have to waste more time getting the payment for healthcare they need.