Can if they need to. If the FAA routinely checked all the airman applications against insurance records there would be a lot of omissions for rather benign medical visits that honestly were forgotten by the applicant.
Computers do a great job of tabulating large amounts of data stored as numerical codes and flagging every questionable one.
They have a never-ending spigot that is really only limited by how much computer hardware they can afford and people to respond to the automated process.
Nobody manually sifts through an entire nation worth of insurance codes. They just give a list of bad ones to the computer and it spits out the results.
OUTER JOIN (pilot_first_name, pilot_last_name, insurance code) where insurance code equals (naughty_pilot_insurance_codes_table)...
In awful pseudo-SQL relational database code.
@gkainz can write a better version of that if you like. LOL. Probably even with indexes to speed up the query.
The major problem with it is Docs who play games with codes in order to get paid or help a patient. You see the code for “mild” skin irritation doesn’t qualify the patient to get prescription topical ointments or the really good dressings, but the code for “moderate” does and the Doc can treat the patient.
Garbage in, garbage out. The computer doesn’t care. But the codes aren’t right and often that gets worse as the price of the procedure needed goes up. In at least some cases, the Doc simply tries again with a code that worked and didn’t get payment denied the last time, as long as it’s “close enough”.
Very few patients even see or notice it. Most insurers don’t publish the codes to the patient, even on the Explanation of Benefits, or if it’s there the patient has no clue what it is.
I get the feeling
@bbchien has seen a whole bunch of medical fiction written down by well-intentioned Docs who don’t realize they’re going to create a paperwork nightmare, because most people don’t have anybody reading that stuff except when the code spits back a “we don’t pay for that one” response from their insurer.
Computers. Such fun. They never forget a number code they didn’t like.
