Ask about alternative procedures or medications. You have nothing to lose, and your life to gain, if you seek another opinion after a diagnosis of a potentially fatal or disabling disease,' Miss Keene writes. The book offers a revealing glimpse at commonly used tactics in managed care. HMOs have become a favorite target of both patients and doctors frustrated by a system geared to provide care at a profit. Take the 'automatic refusal,' for example.
Horror stories abound of HMOs that have refused to pay for procedures.
In fact, many HMOs reject claims automatically, because they know a certain percentage of patients will simply accept the denial. One veteran of several HMO battles describes how his company routinely honored claims, but only after patients appealed their initial denial.