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June 23, 2000

Remote patrol weekend

On paper, tonight's "Dateline NBC" (8, Channel 41) wouldn't seem worthy of a full hour of network TV time. It's about people whose medical claims were denied because the insurance company pulled a bureaucratic fast one. But by the end of this carefully explained report, it's clear this is much more than another story about patients up against a faceless and heartless insurance system. The maneuver is called a "paper review" and, as correspondent John Larson explains, few regulators he spoke to even knew it existed. Larson reports that insurance companies routinely use outside firms to review suspicious medical claims. They're called paper reviews because the doctor never sees the patient while conducting the review. Which can be a problem - especially when the doctor isn't a doctor, but a free-lance journalist filling in a few blanks from a template supplied by the review firm. Factor in a very slippery company president and two hard-luck cases of claim denial and you've got a surprisingly gripping hour of TV. @ART CAPTION:Larson @ART:Photo >>>

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