The entire country is up in arms over managed care and the atrocities committed. There two basic problems in this area, enforcement and compliance. Those in the industry, that is, opposite of the patient say, "When they claim, DENY until they force us to comply. With this stance many give up and the money people win! There are many rules and regulations that can be enforced but unless you know those rules and know what to do they win again.

Pressure Sore Ulcer - Jonathan D. Barnhart

Pressure sores are a constant enemy of a bed ridden patient. The picture is shocking to view but real. This wound DID NOT have to happen! Game playing case management by an employer Risk Manager denying self insurance claims with no medical expertise. This is typical of managed care by proxy and failure to follow expert medical and legal protocols as well as laws and regulations.

NOTE- A popular tactic played is the (He said, She said, They said) - is a vicious ploy of Round Robin laying the blame for approvals, orders, etc. meant to confuse or discourage the patient and family to anger and then they say, "There, you see, How unreasonable they are! Well! What can we do with that anger." Hang Tough! Stay Calm! Be Professional and Matter of Factly! Document!