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79
Burned-Out 19 Y.O. Tired Of Denying Insurance Meds For People In Need Approves 50 Cases And Quits
Interview With Author
Hey, 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
RELATED:
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
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Feathered Dinosaur 2 years ago
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.
Betty Vanderhooven-SchmaaSchmaa 2 years ago
Can I move in with you? America let's us die.
Load More Replies...
Annie Persson 2 years ago
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
Freya the Wanderer 2 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...
Nathan Wolfe 2 years ago
Health insurance is the scam you pay $100+/month for, in the hopes that you'll need it for the last 3-5 years of your life, so they can deny you life saving medical treatment while you slowly fade away, so they don't have to pay anything. It's literally "pay me so I don't have to pay you back".
Noname 2 years ago
Luv, that's not even the half of it in the USA. Have you ever heard of Agent Orange? In Vietnam, the US used chemical weapons that also affected US soldiers. The government denied it for nearly 30 years. I worked for Aetna health insurance which the US government contracted to "ameliorate" the claims by vets serving in Vietnam. If these vets could prove they had been adversely affected, through extensive documentation (often difficult to obtain from the military hostipal archives and the VA). If these servicemen could prove that their ailments were not from family history or current lifestyle, they "might" receive some financial compensation, which was rarely more than a few hundred dollars-nothing that would cover the expenses they had incurred as civilians, and well, Veterans Administration is a joke. I worked documenting these service men and women, their medical histories, their financial abilities (oh, because if you could work, you weren't considered sick).for a company
Load More Replies...
ThisIsMe 2 years ago
My husband is on a prescription where the insurance company will only allow him 9 pills at a time - auto refill every 9 days. Our works schedules are such that is a MAJOR inconvenience to do this way. To get six weeks at a time through insurance is $30. If we pay for it, it would be $200. We are fortunate and able to pay that, so I showed up at the pharmacy willing to pay the $200. Girl behind the counter asked why I was doing this. When I explained she said "that's just wrong", punched some buttons on the computer and went to see the pharmacist. I don't know what happened, but I paid $30 for the pills.
Mario Strada 2 years ago
I have became an expert at navigating insurance companies denials. Unfortunately my wife is very sick and needs certain meds. When they make a fuss, I simply take her to the E.R. every few days. She should go there anyway, but we have learned to deal with it at home so she doesn't have to spend all night waiting (not only we pay through the nose, but we wait interminably). After a few E.R. visits I call the insurance back and usually they allow for the medication or procedure. I tell them straight out "I can take her to the ER twice a week forever, but if you approve the meds/procedure/etc/) that will go away"
Tracy Wallick 2 years ago
The point of health insurance is for the insurance company to make as much money as possible by denying claims. They don't give one single, solitary f**k about you or anyone else; they only care about their bottom line.
Barbara Kayton 2 years ago (edited)
I used to work as temp. I really enjoyed it; especially if I got to stay at a good company for a while. But one company I worked at broke my brain. It was a contract company that was formed specifically so insurance companies had a company to outsource *their* claim workload to. That contract company hired temps - not permanent employees - to handle the claims. And the people who worked on the claims were told, “deny, deny, deny, deny, until the doctors scream loud enough.” So the medical professionals, meant to save lives and health, instead had to spend hours and hours and drown in seas of paperwork to even try to get a life-saving procedure for their patient, only to have it knocked back infinitum. By temps. At a tempoary company. Subcontracted by the insurance company. This is why the American medical system quite literally kills people.
Betty Vanderhooven-SchmaaSchmaa 2 years ago
👋👋👋👋👋👋 applause. More ppl need to act like Robinhood. American healthcare is fukt up. Can't get weight loss drug until after I'm diabetic!!
Feathered Dinosaur 2 years ago
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.
Betty Vanderhooven-SchmaaSchmaa 2 years ago
Can I move in with you? America let's us die.
Load More Replies... Annie Persson 2 years ago
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
Freya the Wanderer 2 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... Nathan Wolfe 2 years ago
Health insurance is the scam you pay $100+/month for, in the hopes that you'll need it for the last 3-5 years of your life, so they can deny you life saving medical treatment while you slowly fade away, so they don't have to pay anything. It's literally "pay me so I don't have to pay you back".
Noname 2 years ago
Luv, that's not even the half of it in the USA. Have you ever heard of Agent Orange? In Vietnam, the US used chemical weapons that also affected US soldiers. The government denied it for nearly 30 years. I worked for Aetna health insurance which the US government contracted to "ameliorate" the claims by vets serving in Vietnam. If these vets could prove they had been adversely affected, through extensive documentation (often difficult to obtain from the military hostipal archives and the VA). If these servicemen could prove that their ailments were not from family history or current lifestyle, they "might" receive some financial compensation, which was rarely more than a few hundred dollars-nothing that would cover the expenses they had incurred as civilians, and well, Veterans Administration is a joke. I worked documenting these service men and women, their medical histories, their financial abilities (oh, because if you could work, you weren't considered sick).for a company
Load More Replies... ThisIsMe 2 years ago
My husband is on a prescription where the insurance company will only allow him 9 pills at a time - auto refill every 9 days. Our works schedules are such that is a MAJOR inconvenience to do this way. To get six weeks at a time through insurance is $30. If we pay for it, it would be $200. We are fortunate and able to pay that, so I showed up at the pharmacy willing to pay the $200. Girl behind the counter asked why I was doing this. When I explained she said "that's just wrong", punched some buttons on the computer and went to see the pharmacist. I don't know what happened, but I paid $30 for the pills.
Mario Strada 2 years ago
I have became an expert at navigating insurance companies denials. Unfortunately my wife is very sick and needs certain meds. When they make a fuss, I simply take her to the E.R. every few days. She should go there anyway, but we have learned to deal with it at home so she doesn't have to spend all night waiting (not only we pay through the nose, but we wait interminably). After a few E.R. visits I call the insurance back and usually they allow for the medication or procedure. I tell them straight out "I can take her to the ER twice a week forever, but if you approve the meds/procedure/etc/) that will go away"
Tracy Wallick 2 years ago
The point of health insurance is for the insurance company to make as much money as possible by denying claims. They don't give one single, solitary f**k about you or anyone else; they only care about their bottom line.
Barbara Kayton 2 years ago (edited)
I used to work as temp. I really enjoyed it; especially if I got to stay at a good company for a while. But one company I worked at broke my brain. It was a contract company that was formed specifically so insurance companies had a company to outsource *their* claim workload to. That contract company hired temps - not permanent employees - to handle the claims. And the people who worked on the claims were told, “deny, deny, deny, deny, until the doctors scream loud enough.” So the medical professionals, meant to save lives and health, instead had to spend hours and hours and drown in seas of paperwork to even try to get a life-saving procedure for their patient, only to have it knocked back infinitum. By temps. At a tempoary company. Subcontracted by the insurance company. This is why the American medical system quite literally kills people.
Betty Vanderhooven-SchmaaSchmaa 2 years ago
👋👋👋👋👋👋 applause. More ppl need to act like Robinhood. American healthcare is fukt up. Can't get weight loss drug until after I'm diabetic!!
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