In the debate over rising healthcare costs, some see managed care as part of the solution, and some see it as part of the problem. Industry representatives, to no one’s surprise, place themselves squarely in the first camp. They blame rising costs on a gaggle of factors not of their own doing—overconsumption by consumers, physician overutilization, and poor-quality care, to name a few. To bring high-quality, cost-effective healthcare to all Americans, the industry has sought to tame these runaway drivers. The industry isn’t alone in seeing managed care as part of the solution. In an editorial late last month, The New York Times included managed care among the solutions to the cost crisis. Properly employed so as not to trigger another backlash, the Times editors suggested, it still has a role to play in keeping a lid on things.

But not everyone sees things that way. continues…

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From Medical Economics magazine, more on health plans ...

Dr. Mehdi Ansarinia, a solo-practice neurologist in Las Vegas, opened his books for a Las Vegas Sun reporter to give an example of how various payers wrongly return about a third of the claims he submits.

The article gives this list of bogus rejections: continues…

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From Medical Economics magazine, more on claims ...