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  • Joe Pallasjpallas@hachyderm.io
    Jul 10, 2026, 5:04 AM

    @joshua I could be wrong, but I think PAMF may have a part in this. If they submit the claim for a lipid panel with a diagnosis code for hyperlipidemia, then suddenly it’s not preventative care, it’s monitoring a disease and not fully covered. I tried to get them to change the diagnosis code once, and they wouldn’t. But the insurance company is the one deciding that tracking my cholesterol level is not routine preventative care if I am already known to have high cholesterol.

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  • Joshua Wisejoshua@emarhavil.com
    Jul 10, 2026, 6:25 AM
    @jpallas I think so too. I had the same experience, that they said 'nah, we're not recoding anything', when I asked them first, but I also suspect this was in part their fault, though.

    My opinions about the Sutter Health monopoly in the Bay are, really, comparably vitriolic to my opinions on the insurers, if not more so. But, annoyingly, they have no regulators to respond to (and the State settled the antitrust case for far too little, IMO), so there's nothing to do about it, so I don't really post much about that kind of thing.
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