From David Pogue of The New York Times
Until a few years ago, my wife was a plastic surgeon. She quit for a lot of reasons, but one was the frustration of getting reimbursement from the H.M.O.’s.
As I understand it, after sewing up, say, a car-accident victim, she would submit the proper forms for payment to the H.M.O. After a couple of months, she’d get back — nothing. As we learned later, H.M.O.’s have figured out that a certain percentage of doctors never follow up; for the HMO, that’s pure profit.
So she’d submit the paperwork a second time. This time, she’d get a check for, say, 60 percent of the billed amount — because the H.M.O.’s knew that a certain number of doctors don’t have the time or energy to fight over every nickel and dime.
And on it would go, until her career felt as though it were half surgery, and half paperwork.
From my outsider’s perspective, it looked like she had stumbled onto a new American business model: passive-aggressive robbery.