I found this appalling

[epileric]

A doctors column talked about how Blue Cross tries to control the doctors in a not-so-helpful way. After reading this I couldn't help but wonder if people in the US should be taking more of their frustrated anger out on the medical insurance people.

Traditionally, a patient encounter is documented with a “SOAP” note: Subjective (the patient’s complaint); Objective (the doctor’s findings); Assessment (the big picture—what the doctor think it all means); and the Plan (that’s pretty obvious).

This works because it is simple and effective. But it isn’t always good for billing. Today, Blue Cross/Blue Shield sent me pamphlet of “suggestions” on how to document my patients’ visits. The acronym is MEAT. It is the way they want us to document diagnoses: Managed, Evaluated, Assessed, Treated. They warn that words traditionally used in medicine (“history of…”, “probable”, “rule out”) won’t do the trick. Apparently these terms express something that is unbillable: uncertainty.

Bad Ideas In Medicine: Blue Cross Tells Me How To Practice

 

[kirsten]

I've certainly noticed this issue become more universal in my country, perhaps because I went onto a medical aid two years back. As a cash patient, doctors would try to diagnose the problem, doing the necessary tests without question. If they couldn't find an answer they would refer to another specialist. These days, the response I get from doctors is, "Your medical aid doesn't pay for that." Full stop. Not even a question about whether or not I would like to pay for the treatment/test myself. My insurance provider says no as a matter of course, so doctors absolutely always need to try a second and third time before getting coverage and most of my doctors are annoyed beyond belief with the amount of time they spend these days sending out motivations. In the end, it leaves us patients with beyond substandard care and with lingering symptoms that destroy our quality of life.