Yea there are cottage industries on top of cottage industries in the medical insurance space. First you have the first order: DR supplies service, bills patient’s insurance, then you have the hospitals who outsource all billing, those outsourced companies outsource the claims management, which outsource the claims response, and the exact same structure exists on the insurance company side. And I’ve simplified a lot… there are coder companies, insurance coder consultants, etc. it’s totally wild.

If you ever wonder why. US medicine is so expensive: it’s bec there are 100 hands all reaching for their piece of your $120 annual checkup.

Or put another way, HIPPA is nice and all, but by the time all is said and done, 8-10 pairs of strangers eyes have seen your vagina fungus infection pharmacy bill.