Brigham Buhler

Bully the clinician to not pull the blood work so then the doctors don't ever do the deep dive so they can't prevent the chronic disease. So now you are headed towards chronic disease because they don't have the ability to help you prevent it. And so that's just one sliver.

Then the other end is as a pharmacy owner, I would bill and collect and I would ship out hundreds of thousands, millions of dollars in medications a month. Crucial life-saving medications for patients. Blue Cross Blue Shield, true story, came, said, they quit paying me. And I shipped out, I think, over a million dollars in prescription medications in a month in the state of Texas.

Then the other end is as a pharmacy owner, I would bill and collect and I would ship out hundreds of thousands, millions of dollars in medications a month. Crucial life-saving medications for patients. Blue Cross Blue Shield, true story, came, said, they quit paying me. And I shipped out, I think, over a million dollars in prescription medications in a month in the state of Texas.

Then the other end is as a pharmacy owner, I would bill and collect and I would ship out hundreds of thousands, millions of dollars in medications a month. Crucial life-saving medications for patients. Blue Cross Blue Shield, true story, came, said, they quit paying me. And I shipped out, I think, over a million dollars in prescription medications in a month in the state of Texas.

You go to negotiate, say, hey, what happened? You guys didn't pay me this month. I have a million dollars that I've shipped to your patients. Yeah, we don't think you collected co-pays and deductibles. Okay, well, we did. We collected 98%. Okay, well, we'll come audit you. Okay, how soon can you be here? Three months. What? I can't ship out $3 million in drugs and float you guys. I'm not a bank.

You go to negotiate, say, hey, what happened? You guys didn't pay me this month. I have a million dollars that I've shipped to your patients. Yeah, we don't think you collected co-pays and deductibles. Okay, well, we did. We collected 98%. Okay, well, we'll come audit you. Okay, how soon can you be here? Three months. What? I can't ship out $3 million in drugs and float you guys. I'm not a bank.

You go to negotiate, say, hey, what happened? You guys didn't pay me this month. I have a million dollars that I've shipped to your patients. Yeah, we don't think you collected co-pays and deductibles. Okay, well, we did. We collected 98%. Okay, well, we'll come audit you. Okay, how soon can you be here? Three months. What? I can't ship out $3 million in drugs and float you guys. I'm not a bank.

And they do that throughout the industry. The hospitals are floating the bills. It's 90 days on average to get reimbursed, anywhere from 60 to 90 days to get reimbursed on a surgical procedure. Then when patients say, why do I have such a big copay? It's another method to discourage you from having surgery and to force you back to the drugs that they're making money on.

And they do that throughout the industry. The hospitals are floating the bills. It's 90 days on average to get reimbursed, anywhere from 60 to 90 days to get reimbursed on a surgical procedure. Then when patients say, why do I have such a big copay? It's another method to discourage you from having surgery and to force you back to the drugs that they're making money on.

And they do that throughout the industry. The hospitals are floating the bills. It's 90 days on average to get reimbursed, anywhere from 60 to 90 days to get reimbursed on a surgical procedure. Then when patients say, why do I have such a big copay? It's another method to discourage you from having surgery and to force you back to the drugs that they're making money on.

Yeah. Now there's still a lot of money in surgery, but it is a loss leader for these insurance conglomerates. And so they put obstructions between you, deny, delay, depose, right? So they delay your ability to get the care. They make you jump through all these hurdles before you finally get approval. You know, UnitedHealthcare denied over 30%, one third of claims.

Yeah. Now there's still a lot of money in surgery, but it is a loss leader for these insurance conglomerates. And so they put obstructions between you, deny, delay, depose, right? So they delay your ability to get the care. They make you jump through all these hurdles before you finally get approval. You know, UnitedHealthcare denied over 30%, one third of claims.

Yeah. Now there's still a lot of money in surgery, but it is a loss leader for these insurance conglomerates. And so they put obstructions between you, deny, delay, depose, right? So they delay your ability to get the care. They make you jump through all these hurdles before you finally get approval. You know, UnitedHealthcare denied over 30%, one third of claims.

And actually two years ago, they denied 37% of claims. Thirty seven percent. That's not one third. That's almost half. Like, let's let's be honest. And all the meanwhile. And what that means is people are dying. It doesn't mean like, oh, shucks. You know, these aren't aesthetic procedures. These are life changing procedures that people are desperate for, that they paid for.

And actually two years ago, they denied 37% of claims. Thirty seven percent. That's not one third. That's almost half. Like, let's let's be honest. And all the meanwhile. And what that means is people are dying. It doesn't mean like, oh, shucks. You know, these aren't aesthetic procedures. These are life changing procedures that people are desperate for, that they paid for.

And actually two years ago, they denied 37% of claims. Thirty seven percent. That's not one third. That's almost half. Like, let's let's be honest. And all the meanwhile. And what that means is people are dying. It doesn't mean like, oh, shucks. You know, these aren't aesthetic procedures. These are life changing procedures that people are desperate for, that they paid for.

And you're denying them. And do you know what percentage of people fight the claim? 10%. 10%. People are tired. How do you fight a claim? You have to go to your doctor and write letters and push back and go get second opinions and take time off from your busy job to go try and battle an insurance company.

And you're denying them. And do you know what percentage of people fight the claim? 10%. 10%. People are tired. How do you fight a claim? You have to go to your doctor and write letters and push back and go get second opinions and take time off from your busy job to go try and battle an insurance company.

And you're denying them. And do you know what percentage of people fight the claim? 10%. 10%. People are tired. How do you fight a claim? You have to go to your doctor and write letters and push back and go get second opinions and take time off from your busy job to go try and battle an insurance company.

And then even if you get the procedure approved and everything's hunky-dory and you go have the surgery, they're going to tell you who to go to, where to go, and then they're They're going to take 90 days to pay the hospital back or the surgery center back. And that surgery center holds the bill. But here's where it gets even more fucked up. They set the co-pays and deductibles.