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Endless Chaos in Obamacare Networks

BEGIN TRANSCRIPT

RUSH: Here's Gus in Houston.  Gus, you're next on Open Line Friday.  Hi.

CALLER:  Rush, great to talk to you.  Appreciate it.  The reason I'm calling, what I do for a living is I sell knee replacements and hip replacements, and one of the ways we do that is by bringing in cadavers for surgeons to put our product in so they can practice putting our knee or our hip in.  We were at a cadaver lab in Texas about a month and a half ago and had a variety of orthopedic surgeons that were putting these knees in. And the conversation turned to billing and insurance, and one of the guys brought up a problem he was having in his office.

And it turned out they were all having this problem.  These guys with Obamacare, patients with Obamacare, present at their office, they give them their cards, they appear to be insured.  That doctor's office will then call the insurance company to make sure they are indeed insured.  It looks like everything's a go, they put a knee in.  When they go to collect the money they're being told these guys were not covered at the time, and they are on the hook for all this money.  These guys are livid.

RUSH:  Wait a minute, now.  Wait, wait, wait, wait, wait.  Just a second.  I need to reconstruct this in my own words to make sure I understand this.  You got a bunch of doctors, and they got Obamacare-insured patients presenting. They get treatment and then they present their Obamacare insurance cards, and the doctors do not automatically assume that means they're good; they still double-check.  So they call and they find out if indeed these people are insured and are covered, and are told they are?

CALLER:  That's correct.

RUSH:  But they don't get paid.  So when they don't get paid, they call back, "Well, sorry.  They weren't insured."

CALLER:  So that insurance company, whatever their peripheral look-see to see if that patient is covered is not the same information they're looking at when they have to write the check, and they're then telling that physician, "Sorry, you're on the hook," and these are big ticket operations.

RUSH:  That is unbelievable.  So they've got two databases. They got a fraudulent database that tells the doctors, A, they're insured, and then later the doctors find out that database is incorrect, that they're --

CALLER:  I don't know that they have two databases.  I think they don't look as deeply as they do when they're writing a check.

RUSH:  But still, it is reported to the doctors that the patients are covered?

CALLER:  That's right.  That's right. 

RUSH:  And then later somehow they find out that they really weren't covered, that a mistake was made somewhere along, and the doctors --

CALLER:  When they go for the money, when they go for the money that's when they find out.  And the doctors office has a team of people in place that that's what they do, they verify insurance.  And so there's so much confusion at the insurance companies that they're oftentimes reporting it incorrectly. And so they may appear to be insured, the patient may think he's insured, but in fact when it comes to time to write that check, that patient's not insured.

RUSH:  So what are they gonna do?

CALLER:  Well, right now they're trying to figure it out.  This happened to be two different groups, and the same problem was happening to both of these groups.

RUSH:  You can't make money sitting on a toilet. It just doesn't work that way.  They're out.  Thank you, Obama. 

BREAK TRANSCRIPT

RUSH:  Endless chaos in the Obamacare networks.  Nobody knows who's doing what.  Nobody knows if somebody's insured.  Nobody can guarantee somebody's gonna get reimbursed or paid.  And even when they haven't been paid the records say they have.  What are the doctors to do but opt out eventually.

END TRANSCRIPT

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