The main reason that doctors lie to their insurance companies is because they try to avoid hassles. According to researchers in the University of Michigan, in order to obtain approval from an insurance company for that patient’s surgery or other medically necessary treatment, one out of 10 doctors claim that they would lie to the insurers.

Dr. Peter A. Ubel, associate professor of internal medicine at the University of Michigan Medical School and research investigator at the Ann Arbor Veterans Administration Medical Centers claims, “The hassle factor had a big influence over the doctors’ actions. If the HMO says no, doctors can appeal, but often, it is a long and burdensome process. So in some cases, physicians lie about their patient’s condition.’

Spokesperson of the American Association of Health Plans, Mohit Ghose, claims “You’ve got to deal with the implications of outright lying. What happens when a patient switches doctors and the medical record does not reflect the patient’s true health history?’

Ubel claims, “There is going to have to be more cooperation between the two. It’s clear some doctors will lie to get what they want when confronted with approval hassles. But the doctors’ goals should be the same as the insurance companies’ – to control costs while at the same time encouraging evidence-based medicine and more reliable [treatment] behavior.’

Ghose then agrees with Ubel. “It’s got to be a partnership between the two. Doctors and health plans must work together to responsibly provide the access to the health care that patients need while following the [health insurance] contracts signed by employers.’

Every lie probably has some sort of reason behind it. Doctors usually tell these lies in order to help their patients, instead of themselves.

However, some doctors have other reasons to lie. Some doctors lie to the insurers of the consumer in order to simply make surgery and receive money for it.

It is extremely important to avoid doctors like these and make sure that the doctor that you have won’t lie for these purposes.

Keep in mind that you can always contact a lawyer for more legal tips in order to avoid doctors who would lie to your insurance company just to receive a fatter paycheck.

When consumers lie to their health insurers, the usually disguise some medical problems that might later result in higher premiums. That is the main reason why lies are made towards the insurers.Similar Posts:

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