> They may be the third-party administrator charging back to an employer,
can you please elaborate on this? does this mean that some companies (employers) directly see and pay their employees medical stuff on their books?
> Ultimately for Anthem, this claim cost them a lot more to handle than if they had just paid out in the first place
... well, of course, but the whole middleman game costs the US many many many serious percents of each year's GDP. and probably the whole culture of reimbursement despair makes a lot of money to insurance companies, and even probably keeps rates a bit lower than they ought to be, and keeps people sick (and of course eventually leads to more serious problems that in turn cost a lot more, but if those are shifted to pensioner age then they might be covered federally, right? again a win for the insurers)
can you please elaborate on this? does this mean that some companies (employers) directly see and pay their employees medical stuff on their books?
> Ultimately for Anthem, this claim cost them a lot more to handle than if they had just paid out in the first place
... well, of course, but the whole middleman game costs the US many many many serious percents of each year's GDP. and probably the whole culture of reimbursement despair makes a lot of money to insurance companies, and even probably keeps rates a bit lower than they ought to be, and keeps people sick (and of course eventually leads to more serious problems that in turn cost a lot more, but if those are shifted to pensioner age then they might be covered federally, right? again a win for the insurers)