Do PBMs Delay Drugs and Drive Up Drug Prices? – The Atlantic

Do PBMs Delay Drugs and Drive Up Drug Prices? – The Atlantic

“Lynn Lear finished her final round of chemotherapy for breast cancer in December. To help keep the cancer from coming back, Lear’s doctor told her about a new medication she could take called Nerlynx. Lear, who is 46, wanted to do everything she could to remain healthy, so she asked her doctor to order the […]

Ohio insurers deny 20% of Obamacare claims: cleveland.com

Ohio insurers deny 20% of Obamacare claims: cleveland.com

“As many as one out of five in-network claims made for Ohio patients with Obamacare are denied, according to research by the Kaiser Family Foundation,” Ginger Christ writes over at cleveland.com. “When a health insurance claim is denied, that leaves patients or providers to cover the cost, leading to unexpected medical bills for patients or […]

Blondie and the beast: Medical coding errors, Part 2

Summary: “Over the course of the past several weeks, I have been helping my friend investigate the root cause of a health insurance claim denial for her daughter’s orthopedic surgery — which has resulted in more than 50 subsequent claim denials and more than $50,000 in undue medical debt for the family — and prepare the external review appeal […]

A mother’s plea on change.org turns around a Blue Cross denial

Filed Under: Costs, Patients, Providers

Guest Post by Amy Gleason This post began from an e-mail Amy Gleason sent to a group of members of the Society for Participatory Medicine. It is posted with permission from Amy. I just wanted to share a positive experience I had as an e-patient (well e-caregiver in this case). I have really struggled with […]