“Pelvic pain had dogged Keith Morgan for years, unresolved by stretching, hot baths, and other therapies recommended at various doctor visits over the last two decades,” Sarah Gantz writes over at our partner, Philly.com. “So when the issue flared up last August, the 56-year-old Montgomery County resident wanted to get to the bottom of it once and for all, with a pelvic MRI. A friend with similar symptoms had recently been diagnosed with a sports hernia after having the scan, and with other causes of his pain ruled out, Morgan thought maybe he had the same affliction. What seemed like a straightforward plan quickly got complicated: Morgan’s insurance plan approved the scan at one doctor’s office but denied coverage at another. A pelvic MRI is among the many services for which insurance companies require prior authorization, meaning that doctors must submit details about the procedure and why it is necessary to get the insurer’s approval. Insurance companies say the process protects patients from unnecessary medical procedures. Doctors, meanwhile, often say the practice is needless red tape that wastes their time and puts insurance bureaucracy in the middle of the doctor-patient relationship. And any patient who has reported for a medical procedure – only to be told at the last minute that their insurer has denied authorization – knows the communication problem all too well.” Sarah Gantz, “His insurer approved an MRI, then denied it. He forked out $2,340 in cash,” Philly.com
Jeanne Pinder is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded ClearHealthCosts.
With Pinder at the helm, ClearHealthCosts shared honors for the top network public service journalism project in a partnership with CBS News, as well as winning numerous other journalism prizes.
She was previously a fellow at the Tow Center for Digital Journalism at the Columbia University School of Journalism. ClearHealthCosts has won grants from the Tow-Knight Center for Entrepreneurial Journalism at the Craig Newmark Graduate School of Journalism at the City University of New York; the International Women’s Media Foundation; the John S. and James L. Knight Foundation with KQED public radio in San Francisco and KPCC in Los Angeles; the Lenfest Foundation in Philadelphia for a partnership with The Philadelphia Inquirer; and the New York State Health Foundation for a partnership with WNYC public radio/Gothamist in New York; and other honors.
She is one of Crain’s Notable Women in Tech. Niemanlab wrote of ClearHealthCosts that “The Internet hates secrets.”
Her TED talk about fixing health costs has surpassed 2 million views.