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November 19, 2003 01:18 AM

Broken: HMO customer service

David Pogue, in a recent New York Times e-mail column, talked about a broken process that I've long suspected: HMOs deliberately slowing down paperwork to encourage people not to pursue getting their reimbursements:

...she would submit the proper forms for payment to the H.M.O. After a couple of months, she'd get back -- nothing. As we learned later, H.M.O.'s have figured out that a certain percentage of doctors never follow up; for the H.M.O., that's pure profit.
Then, on November 6, David Pogue published some reader mail - several readers sent horror stories of their own.

P.S. For international readers, HMO stands for "health maintenance organization," a company that manages healthcare, and costs, for customers. In the U.S. they have a reputation for caring more about cutting costs, and making a profit, than the health of their customers.


Yeah. This is standard procedure for medical insurance co.s. Many of the insurance billers end up dropping the ball. It makes great profit for the insurance co, but your doctor has to raise his already high fees to make up the difference.

Posted by: insurance biller at April 1, 2005 08:19 AM

Y'know what's really broken? Linking ANYTHING from the New York Times, since the link just brings you to their login page - something that's of absolutely no use to those of us who don't subscribe.


Posted by: Christoff at April 24, 2005 05:02 AM

This might have been an interesting read but I could not get into the story/readers letters that the links lead to.

I did not want to subscribe to the LA Times just to read the referenced article in TIB....that is broken!

Posted by: Deana at March 8, 2006 04:41 PM

Oops! Sorry LA Times! I merely looked at the "Times" and missed the "New York" apologies.

How humbling it is to criticize something which is broken, only to end up showing how I too can be broken.

Posted by: Deana at March 8, 2006 04:46 PM

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