Health Insurers Monitoring Patient Compliance

Health insurers monitoring patient compliance – by Eric Umansky (@ericuman) | Twitter – Deputy Managing Editor @ProPublica – Nov 2018

The idea that our health information is any way private is a joke. To allow anyone to treat us, we have to sign a statement giving them permission to access our health records, even the parts they don’t “need to know”.

Anytime we “register” with a new health care provider, we are asked to sign a form giving them permission to access all of our health records, even the parts they don’t “need to know”. Such “providers” are not just doctors and nurses, but often whole hospitals and medical groups (with all their administrative staff) in addition to private companies selling medical devices or services.

So I’m not surprised all this data is being used to deny payments since it’s part of any public corporation’s “moral requirement” to generate profit. (See 400% price hike for drugs is ‘moral requirement’)

1/ A couple of months ago, I discovered my health insurer was monitoring my sleep and using it to deny me benefits. So I told my colleague @marshall_allen…
2/ I use a CPAP for sleep apnea. My doc gave me a prescription to change machine settings and get a new mask.  

3/ A service provider place used to have send a tech to change the settings. Which was annoying (as is the whole Cpap thing, but that’s not the point) Now they said, “We can send you ‘wireless modem’ for your Cpap so we can change your settings remotely.” I was like great!

4/ So my provider sent me ‘wireless modem’ to plug into my Cpap. Awesome! Except I didn’t get the mask that the doctor told me I needed. So I called the provider was like, “Where’s my mask?” And that’s when they said, “Well, you haven’t been compliant.”

5/ My provider said, “We see you u only used your CPAP for 3 1/2 hours Tuesday and only 3 hours on Monday.” And that’s when my head exploded.

6/ Turns out the ‘wireless modem’ my CPAP provider sent me wasn’t just for my convenience! My health insurer required it. They were looking at my effing sleep. And deciding whether I was being “compliant.”

7/ I was — almost — speechless. “You’re monitoring my sleep and using it to deny me something my doctor says I need??? And btw, the reason i’m not compliant is that you won’t send me the thing I need!” “Yes, I’m very sorry,” said the nice lady on the line.

8/ So I got pissed and curious and told @marshall_allen. And it turns out, yep, health insurers are monitoring your sleep and using it to limit benefits.

9/ Also, ps, sometimes a story IS what happens to an editor, even in their sleep. The end.

10/ Oh, I forgot to mention the best part: So after all this the provider has *still* not updated my settings — which was, they said, the whole point of the ‘wireless modem’ in the first place!

Update: I figured today might be a good day to call my CPAP provider and ask them — a third time — to use their “wireless modem” to update my settings, which is what they had said the damn thing was for.

They said they finally did.

2 thoughts on “Health Insurers Monitoring Patient Compliance

  1. Scott Michaels

    When will people learn.? Insurance companies are NOT NOT NOT your friend. They will deny everything if they could and raise your rates at the same time. For medicare to allow insurance companies determine if they want to pay for hight NEEDED doses of pain relievers is the worst joke of all. I wonder how much money the author of that rule git paid on the side by insurance companies. That must change. Insurance companies will never voluntarily pay for anything yet alone NEEDED pain relievers. In the above case, the fact that the used the wireless cpap against the patient is crazy. Next time just turn the machine on when you sleep and off when you wake.. Even if you dont put it on you face. Theyll think your not breathing. Lets see how those money whores deal wih that.

    Liked by 2 people


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