Thursday, August 23, 2012

Gaming the Health Insurance System

We all know that health insurance companies are inherently evil, making money on the outcome of people's health crises. We all know that their priority is money, not helping people. We all know that where ever possible, they will deny coverage and make themselves more money. Money, money, money is all that they care about and anyone who says otherwise is a shill.

A friend of mine has a toddler who needs to see an eating therapist. Yes, I know. An eating therapist? It is hard to get some infants, toddlers, and children to eat properly if at all. My friend's toddler is one of those children.

Insurance won't cover that. We all know (I have been writing this phrase a lot) that good eating - healthy and regular eating - is essential to a healthy lifestyle. At this age, development just doesn't happen as it should without it. One would think that this type of therapy isn't even one of those frivolous preventative measures. If the child doesn't eat better NOW, he cannot develop NOW.

Thankfully, there are caring healthcare providers who are aware of the evil I wrote about earlier. They work closely alongside insurance companies and know the loopholes. They are pretty good at gaming the system. Isn't it complete and utter bullshit that patients, parents and healthcare providers must "game" the system in order to get coverage for care.

My friend's therapy provider found a way where this can be covered by entering all sessions under speech therapy. Speech therapy is fully covered and poor eating habits can lead to poor speech. I'm not sure how poor speech is more of a priority than poor eating. After all, speech affects your social functions and eating affects your physical functions. Either way, I think both should be fully covered.

They will have to keep it to 60 sessions per year because no one could possibly need 61 sessions of speech therapy in a single year. Everyone speaks perfectly within one year at or before 60 sessions. We all know that.

Hopefully, they will be able to maintain the ruse and their son achieves normal eating habits within 60 sessions.



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