Burned-Out 19 Y.O. Tired Of Denying Insurance Meds For People In Need Approves 50 Cases And Quits
Interview With AuthorHey, I get it. Sometimes you really need the money. You gotta work that soul-sucking job until things get better and get out of there ASAP. But maybe you can do some good, even if the door hits you on your way out?
Reddit user jthememeking shared the story of how they got fed up with their health insurance job and right before quitting, they simply approved any and every insurance claim they got.
More info: Reddit
Denying health insurance claims for people who desperately need medical help must be up there with some of the most draining jobs
Image credits: Mikhail Nilov (not the actual photo)
The poster was a 19 y.o. working in a health insurance company, approving or denying claims
Image credits: jthememeking
Image credits: Oregon Department of Transportation (not the actual photo)
As insurance companies want to save everywhere they can, the poster had a miserable time on the job
Image credits: jthememeking
About to quit and being fed up with the job after being reprimanded, they got revenge by simply approving any claim they got
Jthememeking was 19 at the time, working at a health insurance company, with most of their job being denying insurance claims. It’s good that we don’t use aliases at work, though, imagine having your claim rejected by the meme king themselves.
Doctors would call and they’d usually reject them, while the MDs would be going over and above the call of duty to get their patients the care they needed.
Understandably, they loathed their time there, feeling burned out and dreading having to say “no” to someone who just needed medicine again.
So when they were putting their 2 weeks in and got reprimanded over working slowly, they would simply approve every single claim they got, totaling more than 50 by the end of their time there.
To get more insight about the story, Bored Panda reached out to jthememeking and asked them some questions, which they gracefully responded to.
The poster told us that they weren’t in a top-level position that required clearance or anything like that – they were one of the many workers coming and going. Because of the nature of the job, the turnover rate was very high. “From my training class, I was one of the last ones to leave. During my time there, more would come and go,“ they said.
If you didn’t know, insurance companies are required to have a doctor who would review these cases. There was a doctor on site at all times, but OP and other employees like them would be doing the reviewing. The doc would sign whatever they had decided on, without talking about or reviewing the decision.
When doctors would call to demand to know who was making those changes, they had the option of being referred to a supervisor, who, unsurprisingly, also isn’t a medical professional, but has the power to consult with the doctor. “But it’s very difficult to actually talk to a doctor if you were calling us,” the poster finishes.
Image credits: David Hilowitz (not the actual photo)
“I feel like you have to be a certain kind of person to work there long-term. The people who work there for longer than a few years seem so detached from the actions they’re doing,” OP said when asked about if there were people who would stay on the job for long stretches of time.
The job did have some silver linings, as they would usually be helping and guiding doctors with questions involving prior authorizations (PA). “The best times there were when there was a simple solution,” OP says. These would be the times when a procedure or medicine wasn’t on the PA. “I was glad to help when I could.”
According to the comments, OP would understandably have a lot of doctors and pharmacists rage at them, sometimes even letting them in on some tips and tricks to have their claims approved more easily. Once management caught on to them doing it, it was over, though.
According to WorldAtlas, the United States remains the sole country in the developed world without universal healthcare, with about 10% of people without any health insurance coverage, according to 2022 reports. This works out to about 27 million people who have much more difficulty getting help if they need medical assistance.
And for those in the States with coverage, the American Association for Justice (AAJ) published a report titled “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse.”
The report is incredibly scathing, attempting to reveal the shady practices of insurers. “Some of America’s most well-known insurance companies—the same ones that spend billions on advertising to earn your trust—have endeavored to deny claims, delay payments, confuse consumers with incomprehensible insurance-speak, and retroactively refuse anyone who may cost them money.”
It’s a recommended read from us, but what I’d like to focus on is the finishing statement of the report which has also been uttered by OP in a comment. “And most of all, do not give up: Insurance companies count on you giving up. Fight for your rights.”
OP’s story simply exploded, netting almost 13k upvotes and about 700 comments from impassioned readers who shared their own insurance woes. Share your own stories, happy or sad, about dealing with insurance providers in the comments below!
Commenters shared frustrating stories about insurance of their own
170Kviews
Share on FacebookWow. I'm glad to be a doctor in Germany. I get to say which medication or procedure a patient needs. Insurance only needs to approve if a procedure is 'off-label', as not intended to be used for that illness, but something else. And rehabilitation needs to be approved by the pension insurance, which it usually does as it's a lot cheaper for them to fund a rehab than to fund pensions prematurely.
Can I move in with you? America let's us die.
Load More Replies...The American system is WEIRD! I am increadibly greatful that I live in a civilised and social country, or I would have been dead many years ago
I have read that, on average, around 600,000 people in the USA declare personal bankruptcy due to medical bills. That's well over 1600 people a day! But bring up single-payer systems or universal care, and brainless nincompoops belch propaganda about every wino getting a free liver transplant.
Load More Replies...Wow. I'm glad to be a doctor in Germany. I get to say which medication or procedure a patient needs. Insurance only needs to approve if a procedure is 'off-label', as not intended to be used for that illness, but something else. And rehabilitation needs to be approved by the pension insurance, which it usually does as it's a lot cheaper for them to fund a rehab than to fund pensions prematurely.
Can I move in with you? America let's us die.
Load More Replies...The American system is WEIRD! I am increadibly greatful that I live in a civilised and social country, or I would have been dead many years ago
I have read that, on average, around 600,000 people in the USA declare personal bankruptcy due to medical bills. That's well over 1600 people a day! But bring up single-payer systems or universal care, and brainless nincompoops belch propaganda about every wino getting a free liver transplant.
Load More Replies...
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