Insurance Billing Abuse
When we or our loved ones encounter medical problems, the emotions we experience can run the gamut. We often feel overwhelmed, underprepared, and completely blindsided by the changes we observe directly or indirectly. Unfortunately, the same can be said about mental illness and its effect on loved ones and relatives. It has been said that we often feel like a number when we walk through the doors of a hospital, and now, several investigations are attempting to confirm just that. Medical malpractice occurs in myriad forms, and psychiatric hospitals are no exception.
Insurance Abuse
Insurance abuse is nothing new, and fraud takes many forms. One such form is Intake Abuse at psychiatric hospitals around the United States. There are laws in place that require hospitals. By extension, psychiatric institutions care for patients regardless of their ability to pay, provided that the institution or hospital receives any kind of federal funding or subsidy. This means that most individuals will be provided life-saving care in a critical care situation. However, this comes with a cost to the institution providing care, forcing it to find a way to cover its operational costs. Often times those costs are passed on to insurance carriers based on the length of stay of any given patient.
An Empty Bed Represents Profits Lost
What logically follows is that institutions are being paid to keep beds full. An empty bed represents profits lost. Not surprisingly, this situation incentivizes over-diagnosing a patient, misrepresenting a patient’s symptoms (particularly in psychiatric cases), and even screening noninsurance patients, (and subsequently denying admission). In some extreme cases, the institution may not allow the patient to go home at all, and instead enact what’s known in the industry as an “involuntary commitment”. Every state has a law like this, and its purpose is twofold. First, this law empowers the institution to hold a patient without cause if they present an imminent risk to themselves. Second, it is intended to serve those who cannot make medical decisions independently due to many factors. It is important to note that without an imminent threat, these kinds of actions constitute abuse and perhaps false imprisonment.
Psychiatric Institutions Find Clever Ways to Make Ends Meet
Still, psychiatric institutions like this must find a way to make ends meet. There are several ways a hospital might accomplish this. First, as institutions are forced to reduce their already thin nursing staff, less time is spent managing whatever issue may have hospitalized the patient. Subsequently, treatments may be less effective, require longer stays, and generally not produce as positive an outcome as the patient desires. Unfortunately, more extended stays are precisely what the institution wants. When an insurance company authorizes any number of days for a hospital stay, the hospital is incentivized to “max out the patient,” even if remaining hospitalized is unnecessary.
Preventing Psychiatric Intake Abuse
You can prevent Intake abuse in the following ways: Know your rights. Be proactive. Be an advocate. Become informed. Each state has different laws regarding the intake process at hospitals and psychiatric institutions. You can determine your rights by contacting your state’s Department of Healthcare Services (or the equivalent). Once you have contacted them, begin compiling as much information as possible about the incident in question.
More Articles By Ed Smith:
- Personal Injury Resources
- Symptoms of Emotional Abuse
- Financial Abuse
- Post Traumatic Stress Disorder
- Personal Injury Checklist
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