Oh, the beauty of the US health care system! I am two years out from my cancer diagnosis and

[sinkingfeeling]

my ENT just set up an appointment for a PET scan to be done in April. My insurance company requires a 'pre-approval' for such an expensive test. That's all fine, but what gets me is the approval comes from a 'vendor' named CareCore, radiology benefits management firm. Who's concerned about 'benefit rationing', 'death panels', or people who have never examined you making calls about your health care?

Here's what CareCore has to say from their website:

http://www.carecorenational.com/radiology-program-overview.asp

CareCore Radiology, a division of CareCore National, is the nation’s largest and fastest growing radiology benefits management firm. We have the industry's most extensive and current set of evidence-based criteria. Our quality and utilization managment programs provide health plans with comprehensive and robust tools to appropriately manage radiology benefits.

CareCore Radiology covers more than 30 million member subscribers in all 50 states. We work with each client to strategically identify opportunities to improve utilization and enhance quality through seamless solutions that integrate all aspects of patient-centered care.

CareCore Radiology manages benefits for advanced imaging such as magnetic resonance (MRI/MRA), computed tomography (CT), positron emission tomography (PET) nuclear medicine and nuclear cardiology. We partner with each client to:

•Create a dynamic and responsive radiology management program
•Surpass management objectives
•Address provider and marketplace concerns
•Immediate impact on unit cost and inappropriate utilization of imaging services
•Target specific areas
•Increase the quality of service rendered to plan members

[CBGLuthier]

1. Just one more entity with their hands in our pockets.

The american way, everybody gets a cut of everything. Nothing is worth doing unless there is a buck in it to be made and squeezed.

[RC]

4. And you are surprised... Why?

Alan Grayson is correct. Pay in for years then "When you get sick, Die quickly"

[rfranklin]

2. Teabag response: "La-la-la...." (fingers in ears) I can't hear you!

"Keep your government hands off my Medicare!"

[asjr]

3. Even our health has been outsourced.

[Ilsa]

5. Amazing! Nothing about maximizing patient health outcomes..

It's all about making sure the insurance companies get to keep their unearned $,$$$,$$$,$$$.
Why would they want to waste money on sick people? :sarcasm:
An example of disgraceful capitalism.

I hope your recovery is progressing well, SinkingFeeling.

[madmax]

6. Had to deal with the same

bullshit. However, the company who 'manages' these test requests for my insurance company is Med-Solutions and they wouldn't approve a PET Sscan for me but, did approve a CT Scan.

Yes, we have 'death panels', they're called 'insurance companies'.

Gook Luck and keep hanging in there :hug:

[LiberalEsto]

7. They CARE for corporate profits

We shouldn't get any silly ideas that CARE means caring for patients.

[healthjet]

8. Carecore

Dear sinkingfeeling...

I am sorry about your experience. It may help to know that CareCore National is currently under a lot of scrutiny. They lost a huge antitrust case in court recently, and were hit with a 40 Million dollar damages bill by a jury in federal court. see links below. Basically they are a bunch of money-hungry people who stop at nothing to increase their own bottom line. Try lodging a complaint with the department of health or the department of insurance. Don't give up!


http://www.prnewswire.com/news-releases/constantine-cannon-attorneys-win-important-healthcare-antitrust-jury-trial-against-carecore-national-llc-111128319.html

and

http://blogs.forbes.com/danielfisher/2010/12/08/11-million-verdict-shows-dangers-of-medical-cost-control/