Will: [00:00:00] Knock,
hi! Knock, knock, hi! Hello, and welcome to Knock, Knock, Hi! with the Glockenfleckens. I am Will Flannery, also known as Dr. Glockenflecken. I am
Kristin: Kristen Flannery, also known as Lady Glockenflecken. Okay,
Will: this sounds kind of better coming from you. Like, you say Glockenflecken better than I do. Mine sounds like Glockenflecken.
Glockenflecken. But you have like a very classy way of, as classy as you can say, Glockenflecken. Mm hmm.
Kristin: It’s my dainty,
Will: voice. Um, well, uh, we are the Glockenfleckens, uh, and we are excited for you to hear this episode. Uh, I, you’re going to hear me say this multiple times, how just thrilled I am to have this conversation with Maya Miller.
She is an engagement reporter with. ProPublica working on community driven investigation. She specializes in health and [00:01:00] environmental reporting, and she has been doing some amazing work, her and the ProPublica team, uh, surrounding health insurance companies. Now. You guys, you see my videos, you know, I love making fun of health insurance companies, the United and the gang.
They, uh, bring it on themselves for being terrible about everything. And so, uh, it’s one of my favorite things to do. I love making those videos, um, uh, you know, making fun of them and, and kind of hoping to bring to light some of their issues, some of the things that they’re doing around denials and prioritizations.
But, Maya Miller. And her team, the ProPublica team, they’re, they’re taking it to another level. They’re, they are uncovering the, uh, you know, some of the, the shady… You know, under the surface things that nobody’s really knows about. Like, right, like, uh, you know, uh, how, um, how many claims are denied? What’s the process for denying these claims?
Kristin: what are your [00:02:00] rights? What are they saying internally at these companies when they’re denying
Will: these claims? And what are your rights as a patient? What, how, how do you fight back? How do you, uh, uh, make sure you’re being treated fairly? And the work they’ve done, they’ve had three investigative reports so far and more to come.
And so I really, just right off the bat, want to encourage everybody to go uh, to ProPublica and check out these, these reports I think the
Kristin: main, the main takeaway If you, if you listen to this episode, for me, was appeal your denials, appeal, appeal, appeal, because they’re denying, well, you’ll hear all about it, they’re denying things they shouldn’t be denying, and you have a course of action to take after that, that is available to you.
So take it,
Will: please. And I also want to, uh, just tell one quick story, uh, from my own experience. Um, so yeah, I put out these videos where I like, you know, call United Healthcare Evil and Cigna and all these things. Uh, and [00:03:00] I put out one about, uh, prior authorizations surrounding cataract surgery. This is about a year or so ago.
And. Shortly after that, uh, I got a message on Twitter from somebody who said that they know someone in the C suite of a major health insurance company who saw my video about prior authorizations and held a meeting about it. Like an internal meeting, like at the highest levels of this company, uh, where the CMO, uh, uh, was apparently furious and demanded that my video be taken down from the internet.
Kristin: to their internal team that they take down. I
Will: never heard any of this. They wanted the video removed, scrubbed from the internet, as we all know. Not how the internet works. Um, but I, so I, I found that, uh, uh, it, it tickled my funny bone. I loved it. I, it made me, it gave [00:04:00] me motivation to keep going and making videos and doing all this stuff.
It goes to show
Kristin: that like social media advocacy. It gets attention. Yes. It gets the
Will: right attention. Exactly. It gets the attention of the people that need to, um, to be aware of what they’re doing to people. Yeah. And so, uh. One of
Kristin: the common themes I hear, you know, from reading Maya’s reporting was the insurance companies saying, well, we’re not making decisions about your treatment.
We’re not making healthcare decisions. We’re just making decisions about what we will pay for. Which, to anyone who knows anything at all about how American health care works… It’s just such a nonsensical argument, you know, it’s just a straw man because clearly healthcare is so expensive that no one can afford it without insurance.
So by your insurance saying we’re not going to pay for it, they are effectively saying you’re not going to have this treatment.
Will: Well, we, um, let’s get to the interview because it’s a, it’s a long one. This might be [00:05:00] a little bit of a long episode, but we loved it. We had such a good conversation that could have gone on and on forever.
Uh, fortunately our producers tried to like push us along a little bit. So thank you for that because, uh, otherwise we get bogged down and talk about insurance company forever and our heads will explode. So, uh, let’s make sure you’re
Kristin: not, uh, doing anything that you, you wouldn’t want to be doing. Well, very angry when you’re listening
Will: to slightly angry, frustrated.
Wanting to change the system we’ll say. Yes, motivated. All right, here we go. Here’s Maya Miller
All right, we are here with Maya Miller. Maya, I cannot tell you how excited I am to do this And the first question I have for you right off the bat How happy is the insurance, uh, health insurance industry with you right now?
Maya Miller: You know, that’s a great question Yeah, I would maybe not thrilled, but, um, you know, we’ve been hearing from [00:06:00] a lot of patients and, and healthcare providers who seem pretty happy with that work right now.
Will: Well, well, we appreciate you. Um, you’re, you’re not in the ProPublica offices right now. Um, which is, it’s probably much busier over there than where you are right now. Uh, but we really appreciate you joining us.
Kristin: We can relate to, to the insurance companies not being thrilled. I think, uh, Oh yeah. Will here has done his.
His fair share of,
Will: you know, provoking them. Well, you know, I get asked a lot, actually, like, do they try to sue you or something? Like, are they, like, coming after you? Because, because I, you know, do these comedy videos and, and, um, uh, name them, actually, like, I’ll have, like, name United, name Signa. Uh, I think I, I have, like, the added protection of humor.
Like satire, right? They, you know, so that, I think that does give me some protection. You on the other hand, uh, I don’t know, like how, how much animosity is, do you feel that, do you feel a pushback from, uh, health insurance?
Maya Miller: Yeah, that’s a great [00:07:00] question. Um, so we do have lovely lawyers on our staff who, uh, you know, we’ll probably listen to this too.
So I’m going to keep them in mind. Um, but they, you know, read every single story that, uh, we write before we publish it. Um, and we send, we’re in the, you know, practice of sending no surprises letters. So, um, you know, weeks or even months before a story, um, as we. Kind of have gathered the evidence and think we know what’s going on well enough.
We write out a list of questions, um, you know, write out our, what we found, and then we send them to the companies that we’re investigating and say, Hey, you know, will you, would you hop on a call and do an interview with us so we can make sure to get this right? Um, and it’s, it’s been interesting, you know, some, some companies are down to get on.
Actually, I don’t think any company has been open for a phone call yet, but, um, they have been responsive to those emails. And then we, of course, have to include their response in our story. So that’s kind of how we approach that. But, um, yeah, no, we, um, you know, Good. Try to do our due [00:08:00] diligence, of course, uh, before we publish
Will: and you get some legal help there.
That’s, that’s probably good. I, I don’t think we, I need to take it that far, but, uh, maybe I should ho hire a lawyer. I don’t know. Maybe you can give me a recommendation, but , um, I actually want to go back to the beginning of this. Um, and you know, as. As someone in health care, you know, I, I interact with these companies all the time, right?
They’re we’re in it. And so how did you get to the point where, you know, this looking into the practices of these health insurance companies is going to pique your interest? What was the origin of this idea to go in this direction?
Maya Miller: Yeah, so we’ve been teaming up on this work with Patrick Rucker, an amazing reporter with the Capital Forum.
And, um, last summer he got kind of a good tip from a, uh, you know, a couple of sources, uh, people who worked at insurance companies who’ve really helped illuminate some of this work, you know, and who’ve also been some of the people helping us bring this all to light. Um, talking about how, uh, insurance companies do the [00:09:00] work that they do, how they kind of track the cases, approvals and denials.
Um, we’ll have some more upcoming stories on that to come soon. Um, and Patrick came to us and, um, you know, we teamed up with him on, on that work and, uh, just started, we put out a call out. So, um, that’s one of the first things we did is the best. Tips often come from people who are mm-hmm. within the insurance industry who have worked there, you know, healthcare providers like yourself who spend probably hours on the phone with insurers, uh, pretty regularly.
Um, and patients too who’ve been through these denials. And so we put that out and we just got. Barraged with, uh, incredible and, you know, heart wrenching tips, really, uh, people sharing their experiences with denials, people who’ve worked at companies or who’ve had kind of these like moral crises of not feeling like the work that they were doing was what they had signed up for or what they intended it to be, um, and so that, that really drove the work that we have been doing and that we’re going to be continuing to do.
Will: Yeah, that’s, that’s when I first became aware that you were looking into this, [00:10:00] um, uh, I helped to amplify the call for, for, uh, for stories. And I was curious, I wanted to ask you exactly, did you get more than you bargained for? Is that, like, did, were you surprised by the response to a call out on social media like
Maya Miller: that?
Yeah, so, uh, actually, so my specialty is I’m an engagement reporter, so I do community driven investigations, so often turning to the public for help with these kinds of longer term investigations. Um, and I’ve been doing this work for four years now, and I think I’ve never seen the volume that I’ve seen with, um, insurance denials.
You know, I did a series on hospital suing patients for, uh, bills that are overdue, and even with that, um, we saw less of a response. So, I mean, it’s been incredible. We’ve heard from thousands, um, of people, uh, and… Uh, initially it was a little bit overwhelming, but we set up a system to make sure we’re reading everything, um, responding to as many people as we can and, you know, everything that we do here helps inform our reporting and helps us identify themes.
So it’s, it’s been, it [00:11:00] has been overwhelming, but I think that just speaks to how pervasive this issue is across the country. Um, you know, no one seems untouched by these denials. Right. What
Kristin: kind of themes have you identified so far?
Maya Miller: Yeah, so we’ve heard from, um, people who’ve been, we’ve, we’ve heard about denials in particular for certain types of treatments, um, a lot.
So we know that, you know, a lot of scans, MRIs, things like that get held up in denials and can lead to delays in identifying, um, You know, diseases that people have, um, durable medical equipment is another one that we’ve heard a lot about, denials, uh, biologics, or, you know, specialty medications that are expensive, uh, tend to be caught up in the process, and, you know, from one of our actual stories that we did, we found that Uh, UnitedHealth for one of, uh, their patients, like, had a flag for this high cost care.
So, it seems like insurance companies are building that into the system to, to tag these high cost things that, you know, a lot of people, uh, really do need to live their day to day. And so you…
Will: You know, getting the [00:12:00] stories is, is one thing, right? You have all this information coming in, uh, and it really seems like, like you’re, one of your goals for, for this investigation was to just uncover this, these shady practices because it’s, it’s these health insurance companies are so non transparent.
It’s, there’s, there’s so much that the public just doesn’t know about them, and that’s what I found the most fascinating, uh, reading through these, now that I think it’s three stories, three, um, reports that have been put out there, uh, is that you’re able to, to get this in. So I wanted you to, to hear about how difficult it was to uncover some of this stuff.
Maya Miller: Yeah. Um, yeah. So. Pretty, pretty difficult. I mean, we, we always start with a hypothesis, but we’ve, you know, since we’ve been getting so many tips, we’re, we’re kind of now and have these themes, um, we’re knowing what to look out for. Um, and one of the things we’re constantly looking out for is if people are able to get the paperwork behind the scenes or, We’re [00:13:00] really trying to understand what’s happening behind the scenes and with this story that I mentioned with United, um, you know, there was a patient Christopher McNaughton, um, now in his 30s.
He was, uh, he has pretty extreme ulcerative colitis, um, and he had After three, four years of trying to find a treatment for him after his symptoms really developed, was able to kind of work with a doctor to come up with a good combination of specialty biologics that helped keep his symptoms at bay and he was able to return to school and United was covering his care and then he noticed on his case, it said pending.
And so the family reached out and they’re like, Hey, you know, we’ve been working for years to get this treatment. We want to make sure that it’s still covered. They assured them that everything would be fine over a couple of phone calls, but then they saw that. You know, checked in a little later and it said denied, um, and so very few people actually appeal denials in the United States.
There have been some studies that have found that 0. 1% of folks actually appeal, go through with [00:14:00] these appeals, um, talking about, you know, the difficulty of just navigating this process. Is that
Kristin: 0. 1% of people with denials?
Maya Miller: Yes, yes, I think so. So they, there was a study that looked at people who have insurance through the marketplace and that’s where they find that 0.
1% of people with denials, I believe, but I need to read that study. But yeah, no, and so, you know, McNutt Christopher and his family went through with the unusual step of appealing and You know, after they got continued denials, they went through with the even rarer step of filing a lawsuit. And so, very few people end up actually doing that.
You know, it’s money, it’s time, um, but Chris really needed the medication. Um, and so, uh, once they were in the lawsuit phase, they were able to go into discovery. And that’s when they got all the behind the scenes of, you know, what the insurer was actually saying about the case. Um, you know, was able to get a, uh, recorded phone call that.
United employees had about his case and uh, I think it was a peer to peer that had come back and [00:15:00] was denied and um, one of the employees started laughing when they found out, you know, that it was denied and they were like, you know, that’s what exactly what we expected it to be. Um, and so that’s the kind of thing where that’s been, you know, we’re looking for is like sifting through court documents or when, when patients are able to get their claim files, which is something we actually discovered through this reporting process too, is patients can request.
All of the files associated with their claim, um, but yeah, when it’s, it’s not always easy to get and it takes extra time. So, um, it’s, it’s been definitely a lot of work. That was
Will: something that I didn’t even know you could do. Uh, you know, I, I, and something I’ve actually, you know, told patients about now ever since you reported on that.
So, um, that you can… Well, I guess, what is the, have you uncovered like what exactly the process is for, for
Maya Miller: requesting those? Well, you’ve written a guide, right? Yeah. Yeah, exactly. Yeah. So, um, pretty much, and we’re going to actually, we’re working on a form builder to try to make it a little bit easier for folks.
Oh, that’s awesome. [00:16:00] Essentially, you just need an input. your claim information, you know, the cost of your, how much it costs and, um, uh, some more details about your claim and then send it into your insurer. And, you know, legally they’re, they’re required to give you back all of the files associated with your claim.
So that includes audio of, uh, you know, phone calls that they’ve had about your case, things like that. Um, we have seen some insurers stonewall and we are working on a follow up story about that because again, they’re legally required to hand these things over. Um, but yeah, it would encourage all patients and, you know, healthcare providers who have patients to encourage them to request this because it can help in crafting an appeal, first of all, but it could also, you know, just show the insurer that the person is, you know, listening, knows what they’re doing and, um, uh, puts pressure on them to, like, act in good faith a little bit.
Kristin: think that these companies are really relying on people not understanding the process and they’re making the process as complicated and obscure as possible, it seems. So, the more… People can do like what you are [00:17:00] doing and even what Will does, you know, to shed light on these tactics that are going on and to shed light on exactly what is happening behind the scenes and then what the processes are, you know, that allow you to do something about it.
I think that we need more of that because that’s, that’s one of the most powerful ways I think right now that, that patients can get the healthcare that they need is for these, you know, shady practices that are happening behind closed doors to be brought to light.
Maya Miller: Yeah, and, uh, yeah, I’ll just do a quick plug too for anyone who, uh, is interested in looking, learning more about the claim files.
If you listen, if you look up ProPublica. org slash claim file, you can get all the information there. And we actually are developing some kits too, to send around. So some pamphlets that people can have in waiting rooms or support groups, um, for anyone interested.
Will: That’s great. I love that. And one of the more, we’re talking more specifically about the process of denials, [00:18:00] uh, because that’s, that’s been something, one of the most frustrating things, obviously, uh, not just for patients, but for physicians as well, um, is Um, what exactly, who is reviewing these claims?
What are they seeing? What are they, what is their job? Why are they doing this? There’s everything around the decision to make that denial. And in your second story about the Cigna system, uh, that allows these physicians, which they call medical directors, uh, to deny claims. Um, it was. It was shocking, you know, the process that’s being used now.
Can you speak to that a little bit?
Maya Miller: Yeah, absolutely. And I wonder if Jimothy will also make an appearance here. Yes, he’s taking notes. Awesome. Um, yeah, so, uh, we, we found through, uh, you know, doing this work and through people coming forward to us with this information that, um, there’s a process at Cigna, and it appears that, um, it was developed at [00:19:00] United, the person who brought it over to Cigna and potentially a couple of other insurers in which, um, They kind of have a, uh, like a coding software.
So if you send in your claim and it has, um, a CPT code, that’s one thing, and it doesn’t match up with a list of different ICD 10 or codes that they think should be covered, um, then it will just automatically go to a medical director’s. Into a kind of a system that allows a medical director to batch open all of the ones that have been kind of flagged in this way and then Kind of sign off and deny them in batches without opening a patient file So, um, you know, they had a tracking system and they found that it took 1.
2 seconds to deny each of these claims and you know when we when we first saw that number we were like, how is this possible and then To really like, make a decision about a patient’s case in, in 1.2 seconds. And then as we discovered the, the system, you know, we brought it to a lot of state regulators and we’re like, is is this legal?[00:20:00]
And, uh, you know, it’s, it’s a little bit murky, um, but in a lot of states require medical directors who are making decisions about patient cases to be flexible, to be objective, to be thorough. That’s the language that a lot of states are using. Um, and so, you know, I think it’s open question if 1. 2 seconds enables that kind of thoroughness that, uh, the state laws require.
Kristin: I think it’s very… I think it’s clear that
Will: it does not. I think it’s pretty clear to everyone else. You know. Right.
Kristin: You have to have journalistic integrity and can’t be objective about this,
Will: but… You can let me throw out all the insults. That’s fine. You keep doing what you’re doing because it’s certainly making a difference.
Um. And, uh, have you… Were you ever able to connect with one of these medical directors? I, cause they, they seem like they’re not even real people. Like who, who are these people? What is their path that gets them into these positions? Uh, and I’m just, I’m so fascinated by [00:21:00] that. So is that something you tried to kind of get into?
Maya Miller: Yeah, so we’ve, we’ve, um, had the, like, privilege of talking to probably dozens of medical directors so far this year, um, and last year a bit, and, um, you know, a lot of people got into this work, uh, for, it’s a host of reasons. Some were actually burnt out, you know, from just being in Yeah. Yeah. day to day practicing clinical work, um, felt like the system wasn’t working and just needed a break from it and felt that they could, you know, still put their medical skills to use and try to help patients, um, in this role.
So there are some people who come into it with the intention of Oh, this is actually another way we can try to help patients and put our, again, our clinical use, our clinical skills to good use. Um, and then, um, you know, it’s a job where you can work from home. The pay is pretty good and flexible. So I think, um, you know, people who are just for different reasons in their life, either they’re caring for a sick…
parent or like, you know, have a lot of children at home or something like that. Um, it’s a, the people have told us they’ve gotten [00:22:00] into this work because of that flexibility. Um, it also seems like other people are just like the lifers in this work. Um, we have found that some folks, um, like one of the medical directors in the United story that, um, we chronicled Ted.
I think last time he had practiced in clinical medicine was in the 90s and then, um, so he’s been doing this work for a very long time. And, um, so again, I think it’s a different host of reasons why people get into it. And it’s interesting. Some folks are, uh, really You know, certain that this is a helpful thing to do and an important role like they’re like, if you know, this is the way the system exists, I might as well try to be in it and help it from the inside.
And other people, you know, from seeing how the system works are so disgruntled and then want to talk to a reporter and, um, you know, want to try to bring it to light so that there can be some system change.
Kristin: Yeah. And are medical directors required to keep up on, you know, the latest advances in healthcare in the same way that practicing physicians are?
Thank you. Uh,
Maya Miller: that’s a good question. I do believe [00:23:00] they have to be, uh, like board certified, and I, I think so. I, I think you would need to probably maintain some of those, like, testing requirements. Um, but, uh, we have, you know, one of the things that, that’s interesting is, and again, I’m sure people who’ve been on phones trying to fight for their patients know this well, but, um, You know, you can be a neurologist talking or a pediatrician talk trying to get care for someone and talking to a neurologist.
And so, um, there’s also sometimes a mismatch, even if they are up to date on all their specialties, they might not be in the same exact field as the kind of. Treatment that they’re opining on that
Kristin: just blows my mind because you could never have a practicing physician Doing you know somebody who is board certified in neurology practicing pediatrics Why do we allow for it in the people making decisions about what’s covered in what’s not
Can you imagine like me making decisions about like someone’s liver? No, that’s so far away from the eyeball. I know like I would never trust myself to do that. But Also, [00:24:00] you know, they, I’m sure they do have to have some kind of certification, but there are a lot of specialties, oh, they don’t do them anymore, but that a lot of doctors who have lifetime certifications in certain specialties.
I think that’s since gone away, but I think it’s also fair to question, okay, they may have a certificate, but how… How relevant is it to today’s medicine, right? And the decisions that they’re making, um, and I feel like maybe insurance companies kind of hide behind this guise that, you know, these medical directors are.
And how can
Kristin: someone who, you know, is in that situation or has, um, board certification in a specialty that’s not relevant to a case at hand, how can that person say that a treatment is not medically necessary? I see that theme a lot in your stories, that that seems to be maybe the most common, I don’t know, a common, uh, reason for [00:25:00] denial.
And it just seems like that person is… Often not qualified to make that
Maya Miller: decision. Yeah, I think it’s, you know, it’s tricky in talking to these medical directors, I think, um, you know, and some states do require that if you’re reaching a peer to peer level, you have to talk to someone with the same specialty, but it’s kind of a patchwork of state laws, um, that regulates the system anyways.
Um, and so, uh, yeah, I mean, that’s a great question. I think that one that a lot of people Uh, we’ve talked to grapple with and that one that also like can lead to physician burnout, um, from what we’ve heard. Uh, because just like, you know, you’re fighting for your patient and, you know, I’ve talked to some healthcare providers who’ve been on the phone with folks at insurance companies who haven’t even been able to pronounce the, um, like drug treatment that they’re trying to, like, prescribe for their patient that they’re denying.
And so I think that level of frustration and added administrative work can really grind on. on the people who are making the health care system work for patients. Right,
Kristin: and the medical directors, you know, rarely, [00:26:00] if ever, have to actually see the patient and see the, you know, deterioration that’s happening because of all of the delays or denials or whatnot.
It’s the physician that, you know, interacts with those people face to face and there’s just such a large, like, moral injury to all of
Maya Miller: this. Yeah, yeah. I mean, it’s not the most uplifting topic, for sure. You’re getting us
Kristin: fired up here, though. I know, we’re getting
Maya Miller: angry. When you were like, it’s gonna be fun, I was like, oh no.
Like, it might not
Will: be, uh, fun. Fun is a, uh, I also have kind of a twisted way of looking at things. So, um, this is fun. We’re having a great time here. Aren’t you having fun, everyone? This is great. Uh, you know, I think, um, uh, what I found interesting in, in putting out my, compared to what you’re doing, my little silly comedy videos, it almost seems like ridiculous to even talk about.
But the, the social media response, that’s what’s something that I want to talk with you about in the response to your stories as they come out, because, um, I found it, I find it [00:27:00] interesting. You would think that putting out something like this, it’s very critical, obviously, of you just read it, even if you’re objective in your reporting.
It’s obvious, obvious to everybody reading it that, you know, these companies are doing terrible things. Um, I’ve always find it surprising that you’ll read it. You’ll, you’ll hear comments, you’ll hear people that just, that almost don’t believe it, that they’re, that they think, well, they’re doing all this denial, they’re reviewing all these claims, they’re doing prior authorizations, you know, to protect, to protect patients.
And it’s almost like a big PR campaign that, that insurance companies seem to be winning at times, that they’re putting the blame either on physicians or on, on other areas where they’re just, they’re just, just there to protect patients. Have you, have you ever felt that?
Maya Miller: Yeah, I mean, it’s interesting. So that’s something obviously we looked at closely when we were first starting out on this series.
You know, we wanted to like weigh all the evidence, really like, uh, you know, take all the points and assess them, do our due diligence of doing [00:28:00] that research. And, you know, we found that, Healthcare spending, that’s the common argument, right? It’s like, we need the system, um, uh, we need a tamp down on spending.
There’s a lot of, uh, you know, healthcare providers who are doing unnecessary procedures on patients and we’re there to kind of stop them and stop fraudulent billing and practices. Um, And yet, you know, looking at the evidence like we’re actually spending more and have been increasingly the graph is like this Like we’re has been spending more on health care than ever before and you know If you look at us compared to other countries, we’re we’re spending a lot more.
Um, And uh, it’s not like fraud is going down, um in health care either We’ve my colleague actually Marshall Allen who’s now, um He now works at the Office of Inspector General’s office. He left journalism to go kind of investigate on that side. Um wrote a story a couple years ago where he went to insurance companies and said, um, hey like How many cases have you all referred to, like, different federal agencies or state [00:29:00] agencies for, for fraud?
And the number was, I think, like 12, 13. It was pretty small. And so, if, if you’re really, and they’re dealing with millions, tens of millions of claims and cases, so, um, And yet, how many have
Kristin: been denied for stupid reasons?
Maya Miller: Right, and yeah, and that’s something that also my colleague Robin Fields wrote a story about.
There’s just… Also a lack of transparency, as you mentioned, too, that, um, there’s no data, very little data on denial. So it’s very hard to kind of assess to, um, you know, which company is the worst when it comes to denials, like how many denials are wrongful or get overturned on appeals. Um, there’s some data out there, but it’s very messy and dirty.
And so you can’t really do a good faith analysis with it. Um, but yeah, I think it’s an argument that we’ve seen, but because we’ve done our research and our homework on that, we, um. You know, it just doesn’t seem like that’s, that’s the case. What are the
Kristin: insurance companies required to put out there about their denials, if anything?
Are there laws that require them to be transparent that they are [00:30:00] violating, or do those laws just not
Maya Miller: exist? Yeah, so my colleague is the expert in this, and so I don’t want to misspeak, but I believe that there was a law like under the ACA that was passed that required the Department of Labor to collect information on denial data, and it doesn’t seem like that’s been being collected.
States or state insurance commissioners are also collecting all of this data, but we went to every single state insurance commissioner and asked for it, and they were like, no, sorry, you can’t have it. Um, so, um, yeah, you know, that even though it’s a public agency, we expect it to be able to get it. Um, but it’s, it seems like there’s kind of just You know, hoarding or holding onto this data pretty closely so that, again, we can’t have a good look into the system as much as we’d like.
Kristin: have any inkling why they are doing that? Do they, do they offer a reason why you can’t see it? Um,
Maya Miller: that’s a good question. I think that they just, you know, said it’s private information or, uh, you know, something like that. Yeah, I
Will: mean, they’re gonna Aren’t they supposed to be? Well, they, they don’t wanna, they don’t want anybody to know anything about what they’re doing.
Kristin: You know? Well, the [00:31:00] company, sure, but state insurance commissioners should be helping.
Maya Miller: Yeah, yeah, you would hope, but, um, you know, hopefully that data, it becomes more transparent over time. Yeah. Um, we’ll, we’ll see.
Will: How do we… We as in just anybody who’s interested in advocacy work around this issue What are the best steps do you think to take to to help with all of this?
Maya Miller: Yeah, I think that’s a great question I’m curious to hear what you all think to just in your terms of your day to day of working on this but or touching this in your in your work, but um I think, uh, you know, trying to help bring everything to light is really helpful. So, um, you know, talking, unfortunately, like talking to reporters does really help do that.
But if so, you know, even emailing us with your experience can be helpful. Um, suggest submitting your claim file request, trying to get more information from the insurance companies. Um, and I think, you know, when we were working on that Cigna story [00:32:00] about that, you know, 1. 2 second denial mechanism, we saw an internal Cigna.
presentation in which they estimated that only 5% of people would appeal. Um, and so, uh, that was part of like the business presentation on this, you know, implementing this system. And so I think insurers are banking on low appeal rates. Um, and so if you feel like you’ve been wrongly denied, like you, it’s your, totally your prerogative to appeal that.
Um, And while it can be frustrating and time consuming, um, it’s a process that really helps, um, you know, what would, it’s a time consuming and expensive process for an insurance company to have to deal with. So, um, it could, if enough people do it, it can make them maybe, you know, second guess some policies they have on, uh, denying certain conditions or treatments.
Will: That’s a shocking number. Five, less than five percent, I’m sure. It’s just, uh… Well, and just
Kristin: the fact that they’re factoring that in to their politics, it’s disgusting. That’s just disgusting.
Will: What I think, [00:33:00] you know, from my experience on being so aggressively online and social media and everything, is…
Stories are so valuable right now. And I mean, they have been for a long time, but on social media, especially because you can get on Tik TOK and on Twitter, you can get on anything and, and talk about, have put a personal element to this underlying. issue. And I think from an advocacy, social media advocacy standpoint is it’s incredibly valuable to do that.
You know, we’ve done that with, with, you know, whenever I had my cardiac arrest back in 2020, we had all these surprise bills. And so, you know, uh, we were talking about that all the time. Um, and I do think, I think Narratives matter, stories matter, because it puts a face, it puts a, um, a human element to all of this, and so I always encourage whenever I go, you know, speak at places, I just like talk about, you know, the issues you’ve had, the [00:34:00] conversations you’ve had, if you can, with insurance companies, uh, just get with it.
Get more information out there, get more stories out there. Yeah, sharing
Kristin: publicly, it helps, like I said, to just, like, shine a light on what’s happening, and, and they are, for them to be able to get away with what they’re doing, it requires there to not be attention on it. So, I feel like one of the best ways to…
to combat all of this is to put attention on it. And I think what you’re doing, Maya and ProPublica, you know, that’s obviously a very effective way to, to shine some attention on it. Um, you’ve been, well, you’ve been putting attention on it as well, but I think everyone, you know, in this day of social media, everyone has some amount of public influence.
And so sharing your story in whatever public way you have, the more people that do that, I think the more effective we can be at, at making this. system work better for patients and doctors?
Maya Miller: Yeah. Yeah, it’s been very interesting [00:35:00] to see too, like, if you get, I don’t know what, we’ve been trying to figure out, you know, what the system is too, but it does seem like if you complain enough and loudly enough on social media about a denial, it will get overturned, which is really interesting.
Will: That is interesting. I mean, that’s. And it’s so, it’s so infuriating too, it’s like why it’s, it’s, it’s, it’s very clear what I think what insurance companies really still care about, like they care about public image. They do, yep. It’s important to them. And for some reason, I don’t know why they’re so massive and, you know, that you would think that they don’t care what anybody says about them, but like.
You see it time and time again, you know people pile on to them on social media behind somebody’s, you know Terrible story about an insurance denial and sure enough it gets it gets fixed. Um, I don’t know. Yeah
Kristin: Well before we wrap this up, I want I just want to ask about you know What resources do you know of or or would you like to share for people?
Um because insurance and dealing with your insurance company is so [00:36:00] complicated. How can it be? Uh, you know, is there something out there that makes it a little more simple for people? What are the steps they can follow? What are the places they can go to learn how they can appeal their denials and what options are available to them?
Maya Miller: Yeah, that’s a great question. So, um, it’s actually, even appealing can be a little bit overwhelming. I think it’s really dependent on the type of insurance that you have, but I’d say, um, you know, if you jump on a search engine and type in the type of insurance you have and appeal. Um, that should kind of, a lot of insurers do have information on how to appeal on their website.
So, um, just say don’t be intimidated by it. Um, and then the other thing that I would plug is that again, just submitting these claim file requests can be really illuminating and can help show you whether an insurance company is what factors they’re considering when, you know, trying to assess whether to approve or deny your case, whether it’s gone through any of these automated kind of systems at the front end.
So if you visit propublica. org slash claim file, you can, um, kind of get a guide for how to do that. [00:37:00] And we’re in the process again of building a form builder. So, um, I, I guess, yeah, other than those couple of resources, again, I’d just say of the mindset of. When you get something from your insurance company, it can be really overwhelming, especially if there’s a dollar tag on it that, um, will hurt your chances of being able to, you know, pay rent or, you know, put food on the table or, or anything else that you’ve been trying to save up for, um, and so I think just not being intimidated by that and knowing that you have options and rights, um, is, uh, the thing I’d, I’d say is the most important.
Kristin: than just immediately writing the check and paying the bill, you know, you
Will: might want to… Well, well, that’s the other thing. When you get… You know, speaking from our experience, um, it’s never just like one bill, you get just every like week, you’re getting something and it’s from either a different, a different hospital or a different physician or, uh, depending on contracting.
And you don’t even know who all
Kristin: these organizations are, right? Like maybe some other third party was billing you for your imaging, but then you had this other, I mean, [00:38:00] it’s just.
Will: It’s so this is just an explanation of benefits, but it looks like a bill, but it’s not, it says it’s not a bill. It’s so, it’s, uh, but this just speaks to how complicated it is and how overwhelming it would, I mean, it’s almost overwhelming for me as a physician. Right. I can only, you know, imagine what it’s like for someone with no medical training whatsoever who is experiencing this for the first time.
So. So this is
Kristin: certainly, certainly not legal or medical advice, but just speaking as, speaking People who have had a lot of experience dealing with our insurance companies, um, you know, I would encourage people, don’t just, like, reflexively pay that bill. Look into it first, you know, see what your options are.
You may not actually owe all that money. You know, yeah, you
Will: never know if there are mistakes in billing that that kind of thing happens appeal so just I guess I think the lesson is just be diligent and aware and Questioning, you know, that’s always question. Yeah, always question. Absolutely be the [00:39:00] squeaky wheel.
Well, I want to know my We’ll take it actually. Let’s take a quick break and then we’ll come back. We could just talk about this for like forever So this gets us hot
Hey, Kristen, have I ever told you about demodex? I’m afraid. Little
Kristin: eyelid mites. Oh, gosh, no, don’t do that.
Will: Uh, uh. I’m just saying, if you’ve ever had red, itchy, irritated eyes, it could be demodex blepharitis. You might have
Kristin: some little friends on your eyelids. They’re not quite this big. Well, that’s
To find out more, though, you can go to EyelidCheck. com. That’s E Y E L I D Check. com to find out more information about. Demodex Blepharitis. Don’t freak out. Get checked out. Today’s episode is brought to you by the Nuance Dragon Ambient Experience, or DAX for short. This is AI powered ambient technology that really helps to improve the patient physician relationship, which is something I’m sure that you would probably [00:40:00] want, right?
Oh, yes. To learn more about how DAX can help reduce burnout and restore the joy of practicing medicine, stick around after the episode or visit nuance. com slash discover DAX. That’s N U A N C E dot com slash discover D A X.
All right, we are back with Maya Miller of ProPublica, and one thing I wanted to ask real quick before we get into a game that will be very exciting and fun for everyone, um, is where, where are you going next with this investigative series? I’m just dying to know. How much can you tell us?
Maya Miller: Uh, not that much, uh, but I will say, uh, definitely stay tuned for more stories to come.
You’re going to keep going though, right? Yeah, definitely. We’re definitely going to keep going. We have, uh, at least through the end of the year, if not more, we’ve, we’ve heard a lot of, uh, great tips and, you know, we welcome more tips too. So if anyone is listening to this and is like, I’ve had an experience to share that I’ve with an insurance company or I’ve worked at one, [00:41:00] um, you know, we’re here to listen and, um, just really factor that into our investigation.
So we, we have at least. I’d say like two or three more big stories coming up, um, and if not more and yeah, keep, keep the tips coming so we can keep reporting on this. You’ve, you’ve,
Will: you’ve done three reports. If you could just do like 30 or 40 more, it would be, it would be fantastic. Yeah. No, my, yeah. If you want to, if you want to get into prior authorizations, I’m not, I’m not gonna complain about that, and neither will anybody else, so just throwing that out there.
Anyway, um, alright, so we have a game here, it’s called That’s too much. That’s too much. All right, so it’s kind of like a Price is Right game and so I’m going to to lay out a scenario or a question and basically Whoever well, we’ll do it different ways either. Sometimes I’ll ask Maya. Sometimes I’ll ask you Kristen and I’m [00:42:00] gonna be saying different numbers and Escalating You know, in size.
And so, once I get to a number that you think is too much for the question I’m asking, you’re going to say, that’s too much. So we’re trying
Kristin: to guess how much it costs by way of telling you when you’ve gone over the cost.
Will: Yes, exactly. Alright, so, um, this is, I’m going to give this one to, because Maya probably already knows this, so I’m going to give this one to you, Kristen.
Okay. According to ProPublica reporting on a physician’s group suing patients. This is in 2017. The disclosed value of private equity health care deals exceeded…
Kristin: Wait, wait, private equity health care deals, meaning… All
Will: of the deals that private equity has done… To purchase health care practices? As of 2017, yes.
Okay. Total how much? All right, 1 billion, 15 billion. 32 billion, 68 billion, is [00:43:00] that too much? 100 billion. Okay, I just wanted to
Kristin: hear all my, all my opinions. You can’t, that’s not how the game works. Okay, okay, okay. Once you… I’m sorry. I just, first, first round. Practice round. Okay, 68 billion, that’s too much.
Will: Correct. 68 billion is too much. The answer is 42 billion. 42 billion. This is in 2017, so I’m sure it’s probably a lot more now. I don’t know, Maya, if you know the
Maya Miller: exact figure of money.
Kristin: I mean, when 1 billion is your starting point, and they’re just gonna get bigger from there? Exactly. Geez. Alright, alright.
So private equity has paid 42 billion dollars. At least.
Will: It’s gotta be much more now. So, in fact, somebody listening probably knows the the right answer. Now we’re six years after that number. So it’s probably, I don’t know how close it is to a hundred billion, but it wouldn’t shock me. Okay, Maya, this is for you.
Patients who are covered under the Medicare Part D plan now have an out of pocket [00:44:00] monthly cap for their insulin. The cap is 15? 20? 30? 40? 50? Too much, maybe? It was too much after 40. The answer is 35. 35 now is the out of pocket monthly cap for insulin. That was a huge win for Medicare Part D.
Maya Miller: Definitely. I was expecting you to start in the hundreds for some reason.
That just like shows you my jaded, uh. Yeah, exactly.
Kristin: Well, is it jaded or is it just, you know, factual?
Will: I mean, it tells you a lot about, about U. S. health care that we all thought it would be a lot higher, right? Um, actually, and that actually brings me up to another question for you. How do you maintain your own, because you’re reading so many horrible things, right?
About people sending in messages about, um, all these denials and everything, the price of prescription medications, I’m sure is a big part of that as well. Um, how do you maintain your sanity and your, without getting burned out by all of this? Are [00:45:00] you taking care of yourself? Maya.
Maya Miller: Yes, definitely am. Uh, we have a, luckily I’m working with some awesomely talented reporters and we all share the load and talk through it.
Um, and then I also love to go running and, you know, everyone should go to therapy as well, which is helpful too.
Will: Yes. Shout out to therapy. Okay. All right. Let’s do a, let’s do another one here. Alright, let’s give this one to, let’s see, how about Kristen, you try this one. According to ProPublica reporting on rejecting health insurance claims, Cigna doctors used a system to instantly deny requests for payment without opening patient files.
We talked about that. Over a two month time span in 2022, two months, Cigna doctors rejected how many claims using this system? 50, 000? 100, 000? 250, 000? That is too much. What do you think, Maya? It’s
Maya Miller: not too much. It was over 300, 000.
Will: Over 300, 000. Yes. 300, [00:46:00] 000 claims were denied in two months. And that’s just Cigna, by the way.
Like this is, uh, I have to imagine, I mean, we probably don’t know for sure. The other like Blue Cross, United, I mean, do we, do we know what kind of system they’re using? Is it similar? Is that information we know for sure at this point? Yeah, that’s
Maya Miller: a good question. We know that to the person who came to Cigna and helped, you know, get the system up and running to do these very quick denials.
came from United, and so, uh, we have good reason to believe he, you know, started that at United and brought that over, um, and then, uh, we’ve heard about a couple of other of insurers using it, but that’s actually, since we’ve published, a congressional committee is now investigating this, and they’re trying to find out, um, you know, how many other insurers use a system like this.
So, um, stay tuned, and we will know more, um, hopefully soon.
Will: All right. Maya, what is the cost of a [00:47:00] vending machine Diet Coke from my local outpatient surgery center? 75 cents. One dollar. Two dollars. Too much. No, it’s two dollars and fifty cents. Really? Two dollars. Yes! That’s pricey. It’s pricey, right? I mean not to the scale of some of the other things we’re talking about but still very important Doctors, everybody, healthcare workers, they need their Diet Coke.
Okay, that was that was just a fake one I mean that was true. But you know, anyway, let’s do one more. Here’s the last one. Okay, who’s it for? It’s for Maya Okay. All right. In the Bill of the Month NPR series A patient was billed, what amount for an air ambulance ride from the University of Colorado near Denver to Duke University Medical Center in Durham?
That’s a long ride. It’s a long ride. All right, what was the, how much was the patient billed for that? 000 450, [00:48:00] 000 550, 000 I’d say 550, 000 Yes, that is too much. The answer was 489, 000 Right in between. Wow. For, for an air ambulance ride. Just to get
Kristin: to the healthcare you need. Yes. Obviously there must have been something very specific about Duke that made them go that far.
So just to get to where you needed to be. And I What kind of person has that money?
Will: And I shudder to think what insurance covered for that.
Maya Miller: Yeah. I don’t know. Yeah, we’ve seen a lot of those surprise bills out of air ambulances, uh, or like, yeah, the helicopter rides. Um,
Will: and you know, a lot was made over with surprise billing, you know, speaking, speaking of that, um, of the no surprises act, but I, I still, I feel like I still hear a lot of stories from people that like, you know, insurance companies are kind of skirting around it a little bit or figuring out ways to chill, still treat things as out of network.
I don’t, I think it’s [00:49:00] helped, but I, I’m dubious, I guess. That, um, insurance companies, you know, are not still doing things. Right. You’re still kind of not doing what they’re supposed to be
Maya Miller: doing. Right. That’s a good tip. I will, we’ll, we’ll have to look into that.
Will: Yes, please do. Um, that, so that was, that was the game.
That was the. That’s too much.
Kristin: I think it’s all too much is what we have learned. It’s all too much.
Will: It’s all too much. Um, so
Kristin: Maya. Everyone go to therapy now. You’re welcome.
Maya Miller: And don’t have a Diet Coke anymore to help make you feel
Will: better. Yeah. Let’s take one more quick break and then we’ll come back and wrap things up.
All right, we are back with Maya Miller. So the last thing we’re going to do here, Maya, is have you listen to one of these medical stories that was sent in by our listeners. We like to share these with our, with our guests and with our audience. So first, actually we have one [00:50:00] story here today, this is from an anonymous listener.
I am a certified. Pharmacy technician, and I listened to the podcast about the leeches. I don’t worry about that. We just, we talked about leeches, just, just leave it at that. I work in retail, but one of my friends had recently switched to hospital pharmacy at a local university hospital. It was her second week on the job and she loved it so much and would send me Snapchats of all the cool stuff she was getting to do.
One day I got a text from her that said, you need to check your Snapchat immediately. As soon as I opened it up, I see a picture of a live leech. In an amber vial, like a pill bottle, with the caption, I never thought I’d be delivering a live leech. To a hospital floor in my career, but here we are. I believe it went to surgery, if my memory serves me correct.
Uh, and I can safely say I have seen a live leech being dispensed at an inpatient pharmacy. So, Maya, how much did the live leech cost? Five dollars. No, I have no idea what the going rate for [00:51:00] leeches. That’s a good question. Yeah,
Kristin: now I’m curious.
Maya Miller: Hopefully, I think more than the coke. Like, at least double that.
Will: Yeah, yeah, I hope so. Um, I also wonder if that’s a reimbursable. We actually have
Kristin: learned. Did the leech get paid for its contribution to patient
Will: care? I imagine it probably did not survive, but it got a nice meal before it went away. Um, yeah, we actually learned Maya that you may be interested in, or maybe not interested at all, but, um, uh, leeches.
Are actually still used in medicine today in very specific situations regarding like skin grafting and in like, uh, plastic surgery, vascularity, things like that. So the more
Maya Miller: you know, that is very interesting. Actually, is it, is it pretty rare for
Will: them to be used? I don’t think it’s common. I
Kristin: can’t imagine.
Will: use them on the eyeball, so I, I have limited knowledge in this situation, but, uh, uh, you know, other people can [00:52:00] tell us. This is like the third episode we’ve talked about leeches. I know, people are really fascinated by them. Yeah. Anyway, again, if we have a leech specialist listening, please get us, you know, get in touch with us.
Well, Maya, thank you so much. It’s really been a pleasure talking with you. I’ve just been dying to have this conversation and just, uh, it’s, uh, I just want to say Thank How thankful I am on behalf of the entire, you know, medical community, because every time you come out with a report, I share it all over social media and, uh, I know that people really, they get mad, they get angry, but also there’s like relief, that, that somebody’s looking into this.
information is getting put out there and, uh, these shady practices are being exposed. And so, uh, you have the entire medical profession behind you in terms of, you know, continuing on with these investigations.
Maya Miller: Yeah. Well, no, thank you so much. And thanks so much for amplifying the work. It’s, um, really, really been helpful in terms of [00:53:00] connecting with more insiders, with more patients and healthcare providers who’ve helped us.
You know, do these stories and find them. So, um, yeah, really grateful for you all for having me on and for continuing to, you know, help us get this work out there. Absolutely.
Will: And I want to make sure that we kind of reiterate some of the really important things out there. So, um, uh, they can. Obviously find these, uh, reports on ProPublica.
That’s right. Yeah. And then you also, um, the, the, you’re designing those kits for healthcare professionals, patients, um, who lead support groups and other patient advocates, uh, that, uh, can help them, you know, file a claim request with an insurer. That’s really important to, to remember. Uh, and there’s a signup process.
Maya Miller: that right? Yeah. If you want a kit, we’ll mail them out to you. And if you also want to just, uh, tell us about how your claim file request experience goes or share the records that you got back so we can also have a peek under the hood with you. Um, everything, you can find everything at ProPublica. [00:54:00] org slash claim file.
And can people share with you anonymously? Yes, absolutely. All
Will: right. And then, uh, are you on social media? Yes. I think you are,
Maya Miller: right? I’m on Twitter. I guess, X. I don’t know if it’s X or Twitter now, um, as of today. Um, probably gonna… What is it today? I don’t know how long I’ll be on it for, but, um, I’m on Twitter at Maya T.
Miller, so feel free to follow me there, and I’ll post about our most recent work there, too. Awesome.
Will: Well, thanks again. Yeah. Thanks for having me. Take care.
Well, I am fired up. Yeah, I, I’m ready to run through a brick wall , probably, please don’t think get severely injured, but then we would have more insurance bills. Oh my God. That probably get denied. I don’t think there’s a C P T code. Did I say C C C P T? You don’t even know anymore. Anymore. Chad. G P T C P T.
I CD I C T. What am I talking about? No, C p T codes are a thing. Um, uh, ICT,
Will: 10. Oh [00:55:00] my god.
Kristin: Billing. There’s no billing there’s
Will: no billing code for running through a brick wall because you’re angry about an insurance company. Hmm. Uh, doing what they do. But that was awesome to, to have Maya later
Kristin: on. Yeah, very,
Will: um, enlightening.
Man, gosh, uh, just horrible things about the US healthcare. There’s bad things about every healthcare system, but it seems like we got a lot of
Kristin: them. Yeah. Yeah, they’re doing important work by by Bringing all of that to public attention. That’s
Will: for sure. Definitely reach out to her and the ProPublica team if you have like really Really good stories really anything, you know that they’re they’re they’re so good about using that information to to kind of springboard into Investigations of all these companies.
So, uh, and let us know what you thought of this episode. We’d love to hear it. Uh, this was, uh, as is it such an enlightening, [00:56:00] intriguing conversation. So we want to know what you think. Uh, there’s lots of ways to hit us up, email us knocknockhigh at human content. com. Uh, we’re on all the social medias and kick it with us and our human content podcast family on Instagram and TikTok.
At human content pods also. Like, did you like this? The game? What’d you think of the game? Oh, it’s fun. That’s too much. Yeah, it, I know that there are some prices, right? Connoisseur out there. Mm-hmm. . Um, if you have, uh, that there’s like a price right game that we could like turn into a, I wanna do the one where you could just spin the big wheel.
That, that would not, we would need a big wheel. We would need a big wheel and that, that’d be hard for an audio format. This think it’d be fun. Uh, but if you’re not, if you watch us on YouTube it would work because we are there as well. I post, uh, an episode every week on YouTube. Um, we also, uh, I want to shout out our great listeners, leaving feedback and reviews.
If you subscribe and comment on your favorite podcasting app or on YouTube, we can give you a shout out. Like BigFan001 on Apple said, Dr. [00:57:00] Fitzharris was amazing. She really was. She was fantastic. I mean,
Kristin: we’re still talking about her episode in this one. The leeches came up. Yes.
Will: Best interview to date.
Please bring her back. Her energy is infectious. Love the podcast. Keep up the great work. Thank you, big fan 001. Big fan. I think more of a big fan of Dr. Fitzharris. Seems
Kristin: like it. And that’s okay.
Will: That’s okay. We’ll take it. That’s alright. She has got a lot of big fans, including us. Again, check out YouTube for video episodes.
We also have a Patreon, lots of cool perks, bonus episodes, where we react to medical shows and movies. Hang out with other members of the Knock Knock High community. We’re growing. We’re a big community now. We’re like a small town. It’s great. Uh, you get early ad free episode access, interactive Q& A, live stream events, a lot more.
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Hey, Kristen, let me tell you about DAX. Who’s DAX? Yeah. DAX is the Nuance Dragon Ambient Experience. They call it DAX. I kind of like the name. It’s AI powered ambient technology. It sits in the exam room with you and does so much. Most importantly, I think it helps. The patient physician relationship. How so?
Well, it’s, have you ever been in the room with your doctor and felt like they were more focused on the, the medical record system versus you? Yeah, like
Kristin: if I’m talking and they’re looking at the screen and typing instead of looking at me. Yeah, we just
Will: have so much to do, so much documentation. Right. That it [01:00:00] just makes our, Attention’s pulled in different ways, but DAX, it captures all the relevant information and helps with your administrative burden and, and just allows us to talk with each other.
I like that. Yeah. To learn more about the Nuance Dragon Ambient Experience or DAX, visit nuance. com slash discover DAX. That’s N U A N C E dot com slash discover D A X.