Health Insurance, peer to peer reviews – My head might explode

I was raised by 2 doctors. Not wealthy doctors, but doctors who became doctors to help other human beings. My mom died of cancer early, but my dad is 90 and he still sees patients on occasion. He also teaches a few classes with his 2nd wife. He made enough money to pay his bills, but he can’t just up and travel, and he certainly did not make enough to leave his kids much (not that I am complaining at all). Anyway, he is now on a decline after falling 2 weeks ago and breaking his hip, and he is laying in a hospital bed without physical therapy because the insurance companies keep denying it. SMH.

The hospital has cleared him for discharge, but the insurance company has not approved his stay at a rehab center. Instead, the past 5 days have been spent with “peer to peer” reviews, and appeals about the insurance coverage for his physical therapy. And he lays in bed with no physical therapy, just waiting. And of course, being billed for hospital days.

The system is absolutely crazy. I have never seen such inefficiency in my life. Like, what the f+ck is evening happening here, and for 5 days now? Does some “peer” at the hospital call some “peer” at the insurance company, and they debate this out? And why 5 days? Do they leave messages for each other, if someone does not answer the phone? Are they speaking every day?? I know for sure that if any intelligent adult observed kids behaving like this, they would be like: “Hey. Knock it off and just make a decision already.” Absolute bullshit. I am really at a loss for how this system got into such an inefficient f+ck-mess.

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