Tag: Patient Advocacy

Why the Same Drug Costs 3x More (And Who Decides)

        THIS TIME ON CODE WACK!   Imagine two patients … same diagnosis, same medication, same country.  Each one needs the same prescription. One gets their care through the Department of Veterans Affairs, the other gets it through Medicare. The price of […]

Designed to Fail: How Insurance Denials Really Work

          THIS TIME ON CODE WACK!   Today, we’re talking about insurance denials, hidden incentives… and why getting care can feel like navigating a system designed to stop you. Our guest is Bob Coleman, a retired healthcare professional who spent more […]

States Push Back Against Medicaid Managed Care

            THIS TIME ON CODE WACK!   Today, most people on Medicaid get their care through private insurers called Managed Care Organizations, or MCOs – like Aetna and UnitedHealthcare. Critics say these companies add layers of bureaucracy that make it […]

The Middlemen Making Money Off Medicaid

            THIS TIME ON CODE WACK!   Why are there middlemen in Medicaid – and what are they doing to our most vulnerable patients and physicians? How and why are private insurance intermediaries permitted to put profits ahead of patients? […]

The hidden forces behind skyrocketing health insurance costs

        THIS TIME ON CODE WACK!   Join us on a deep dive into the hidden forces behind soaring out-of-pocket costs, from rising medical costs to pandemic aftershocks and corporate profit pressures. Our guest, health insurance agent Sherry Davis Johnson, shares eye-opening […]

‘Widespread Panic:’ Rising Premiums and Shrinking Subsidies Explained

      THIS TIME ON CODE WACK!   We’re digging into big questions: Are reduced health insurance subsidies leaving Americans with a bad case of sticker shock? If you’re shopping on the ACA marketplace, what should you watch out for before picking a plan? […]

Love your Medicare Advantage plan? It does NOT love you back

          THIS TIME ON CODE WACK!   Will Humana and UnitedHealth Group be found by the courts to have prematurely denied or cut off physician-ordered post-acute care for Medicare Advantage members using AI models with error rates as high as 90%? […]

BS, Gaslighting & AI: Demystifying the health insurance denial process

            THIS TIME ON CODE WACK!   Imagine watching your mom suffer a stroke and two seizures that left her unable to use her right side… and then having her Medicare Advantage health insurer deny coverage for the nursing home […]