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ESWT and Insurance

Posted by Archie B on 5/28/03 at 07:30 (120112)

Just a thought- why don't all the podies completely refuse to perform invasive PF surgery and only treat PF with conventional therapy and then with ESWT of their choice when the case is refractory regardless of whether or not the insurance thieves pay for the procedure. Then in each successful ESWT case that is not paid for both the podie and the patient sue in small claims court and demand a jury trial. I don't believe that any jury in this country will side with the insurance bandits. It works real well. I have done it several times and as soon as I requested a jury trial instead of having the case heard by a judge the insurance bandits took off their masks and wrote a check. Now the trouble with the plan- the patient might do it but the greedy docs will rather cut and sew because they are sure of getting their greedy pockets filled.
Don't bother with the boring comebacks such as- I spent 10+ yrs. plus before I started making a decent living - Do you know how much I owed in tuition loans?- Do you know how old I was before I started makinfg any money? - Do you know how much my malpractice insurance is?- I spent as many years getting my university degrees as any doc and I owed as much when I graduated as any doc and that doesn't guarantee me the lavish living that docs believe that they deserve. It time that docs stopped putting their bank accounts totaly before the welfare of their patients.
Oops- sorry, I must have put too many spoons of fantasy in my coffee this morning. Who am I too think that docs might have a heart instead of a $ sign in their chests.

Re: ESWT and Insurance

BGCPED on 5/28/03 at 22:57 (120235)

Well Mr Arch I think you have taken the gauntlet from me as 'THE BIG NASTY'

Just a few observations from me.

If you are that upset at the perceived imbalance in wages-v-time in school etc. I am not sure what your profession is but we are in a free market society and let the chips fall. A person that has toiled at karaoke every weekend for 10 years can get pissed and say, the fat dude on American Idol is getting a multi million dollar contract and I have worked just as hard as him its not fair....you want fair go to Russia. oops I mean Cuba no not there either.

The reality is there are good and bad in both patients, doctors and health insurance companies. There are idiots, liars, cheats and incompitant fools to the equal degree in all of those examples.

I am also curious if you could give examples of all the times you have won via the jury trial threat. If I am not mistaken most insurance policies have a very detailed course of dispute you must follow. They want to drag you through arbitration. Did you follow all of those protocols for each of your situations? They are put in place for that reason so they dont get a bunch of people taking them to court over everything.

I am not saying they dont deserve it in may situations. If you sue a corporation in small claims they will pay the $35 fee and kick it to circuit court to cause you more trouble and to get their attorney involved. You can fight them representing yourself but many judges dont look kindly on self representation.

There is probably a long section explaning conflict resolution in your contract. If you just called every time there was a dispute and said'I will get a jury trial and sue' and they paid it then please give us the name of your health care provider.

P.S. do you like Liberals? If you dont I have job for you on the social board

Re: ESWT and Insurance

Archie B on 5/29/03 at 07:29 (120250)

Don't even mentions liberals- I think G-D made them with stuff left over after he created the Black Plague.
It's really nobody's business here or anywhere else how, when where, etc, I managed to sucessfully litigate with the medical ins bandits. Let it suffice to say that I have been successful numerous times. Just for the record after the first 2 decisions in my favor they simply gave in to each and every subsequent threat. The most recent time was for a medical device that costs $15,000 and that they considered to be not effective. It was for my grandson whom I have custody of and who has a significantly life shortening genetic disease. I bought it myself, filed a claim and it was rejected. I wrote to the head bandit of the board, included a picture of my 7 yr. old grandson, and asked him if he really thought a jury would deny this child this device which his doctor said would help him. A check for the full amount followed very quickly.
If you want to continue this post your reply to the social board please.

Re: ESWT and Insurance

Dr. Z on 5/29/03 at 21:39 (120328)

How to get the judge to switch to a jury. I would like to try this for some patients. Do you just make a motion in writing.

Re: ESWT and Insurance

BGCPED on 5/29/03 at 22:02 (120329)

You can request a jury or bench trial. Sometimes one is better than the other. Bench is many times better if you have facts on your side. Jury is better if all you have is bullshit or emotions to play on. Not saying it is right or wrong and there are smart juries out there but it is a crap shoot. remember the OJ trial that was a case that a first year law student could win.

I still am amazed at all the dream team b.s. They were a group of rag tag publicity hounds. Cochran had 2 criminal cases before oj and shapiro was a shyster. f lee was a has been tax cheat. The one idiot juror that was interviewed after they let oj the killer walk said it best. Reporter asked her 'what about the DNA' she said ' I dont know nothin bout no DNA'

There you have it, if someone can explain it differently then tell me please