Wednesday, January 12, 2011

Ugly America

It's not all sunshine and roses here in Israel (ok, maybe sunshine), but recent dealings with U.S. lawyers and healthcare insurers have reminded me just how pathetic some American social systems are. 

The lawyers
We have assistance from lawyers as part of our relocation to ensure that we can be in a foreign country legally.  The work is outsourced to an American firm, which acts as a third party liason between corporate and the local country lawyers, who actually do the work here.  The American firm (ask me if you want to know which one so you can avoid them, although I have little faith that they are an exception to the rule), has done nothing but worry the local firm about the scope of help they can provide.  AND, they are now bullying the local firm against working with us directly (at our own expense) so that THEY can upcharge and take their piece of the pie.  Behavior like this should be criminal. 

Health insurers
Our plan offers 15 visits of accupuncture per calendar year, per person.  I have asked at least 6 phone agents since we got here whether there are any restrictions or special "medical necessity" paperwork required.  I have been told as many different answers.  Reading between the lines (or piecing together the bits of information they have let slip), there seems to be an internal list of which diagnoses they will actually approve in the claims processing department.  However, this list is not printed in any materials that they make public.  I have been able to get phone agents to rattle off parts of the list - coverage for pain, but not for carpel tunnel syndrome, for instance.  All I can say is, if you're going to provide coverage, do it.  If you're going to restrict it, put it in writing, and arm your customer service agents with the same information you give your claims processing agents.  Don't tell me that "acupuncture is covered, no pre-approval needed," and then reject a claim because the diagnosis was on your secret do-not-fly list. 

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