In the words of a "medical biller", how one person who works "hands on" views the practices of insurance companies, and maybe this is perhaps why the so very long process and delays occur, and one other point made, they earn interest on the money until it is paid out. BD
I have worked in the health-care field, predominantly professional billing, for more than 20 years. In the past several years, health-care insurance companies have been setting up "false edits" in processing claims from health-care professionals for payment due. I refer to these as "false edits" because these procedure codes are falsely tagged for nonpayment by the insurance companies. These edit systems contradict recognized coding edits and guidelines.
The insurance companies do this to slow down payment to the health-care professional. After the insurance company denies the claim, then an appeal process is initiated by the health-care professional. It is not uncommon for the appeal process to take six to eight months. In the meantime, the insurance companies are earning interest on what they have not paid the health-care professional.