#76. Insurance Denied $400,000 in Care — A Healthcare CEO Explains How the System Really Works

What happens when insurance denies over $400,000 in medical care? And who actually benefits when your claim gets rejected?

In this episode of Heal Without Harm, Dr. Clayton Dir PT, DPT sits down with Kellie Chastain — CHNC and CEO of Evolve Healthcare of Kansas — for an insider look at how the healthcare system really works from someone who has spent 30 years inside it.

Kellie has held nearly every leadership seat in healthcare: medical records clerk, Director of Revenue Cycle, Director of Operations, CFO, and now CEO. She knows exactly where the system breaks down — and more importantly, what a better model looks like.

This is the episode for you if you've ever felt frustrated, confused, or failed by traditional healthcare.

━━━━━━━━━━━━━━━━━━━━━━━━

WHAT YOU'LL LEARN

━━━━━━━━━━━━━━━━━━━━━━━━

— The real story behind a $400,000 insurance denial and what it reveals about the system

— Why insurance companies deny claims and how the revenue cycle actually works behind the scenes

— The difference between "sick care" and true proactive healthcare

— What direct, patient-first healthcare models like Evolve Healthcare do differently

— How to find a doctor who puts you first instead of your insurance company

— What questions to ask before trusting any healthcare provider with your care

━━━━━━━━━━━━━━━━━━━━━━━━

ABOUT THE GUEST

━━━━━━━━━━━━━━━━━━━━━━━━

Kellie Chastain, CHNC, is the CEO of Evolve Healthcare of Kansas, with a Bachelor's in Business Administration from Fort Hays State University and an MBA from Chadron State University. Evolve Healthcare was born out of frustration with the traditional sick-care system and built around proactive, patient-first care.

━━━━━━━━━━━━━━━━━━━━━━━━

FREQUENTLY ASKED QUESTIONS

━━━━━━━━━━━━━━━━━━━━━━━━

Why do insurance companies deny claims?

Claims are denied for many reasons — coding errors, lack of pre-authorization, "medical necessity" determinations, and policy technicalities. As Kellie explains, the financial structure of the system means denials can serve the insurer's bottom line, not the patient's health.

What is the difference between sick care and healthcare?

"Sick care" reacts to illness after it appears, often through medication and procedures. True proactive healthcare focuses on prevention, root causes, and keeping patients well before problems start.

What is direct or patient-first healthcare?

Patient-first models like direct primary care remove much of the insurance middleman, allowing providers to spend more time with patients and focus on outcomes rather than billing codes.

How do I find a doctor who puts patients first?

Look for providers who offer transparent pricing, longer appointment times, and a proactive approach to your health. Ask how they handle insurance and whether they prioritize prevention over reactive treatment.

━━━━━━━━━━━━━━━━━━━━━━━━

CONNECT WITH DR. CLAYTON DIR PT, DPT

━━━━━━━━━━━━━━━━━━━━━━━━

YouTube: https://www.youtube.com/@TheDocDir/videos

Instagram & TikTok: @thedocdir

Email: TheDocDirOfPT@gmail.com

Main Page: TheDocDir.com

Please subscribe so you never miss an episode, leave a review to help the show grow, and share it with a friend who's frustrated with the medical system.

Heal Without Harm is hosted by Dr. Clayton Dir PT, DPT and is for educational purposes only. It is not a substitute for personalized medical advice.

#HealthcareSystem #InsuranceDenied #BrokenHealthcare #DirectPrimaryCare #PatientFirst #HealWithoutHarm #TheDocDir #SickCare #HealthInsurance #ProactiveHealth #EvolveHealthcare #MedicalSystem #HealthcareReform

Tämä jakso on lisätty Podme-palveluun avoimen RSS-syötteen kautta eikä se ole Podmen omaa tuotantoa. Siksi jakso saattaa sisältää mainontaa.

Jaksot(83)

#82. Menopause struggles? How to train and eat right with the correct guidance ft. Hanna Rosov

If you've been told to "just eat better and move more" and left with zero direction, you're not alone. In this episode, Dr. Clayton Dir, PT, DPT sits down with Hanna Rosov, an ACSM-certified personal ...

20 Heinä 0s

#81. IT band pain? How to heal outer knee pain with the correct approach

IT band pain? How to heal outer knee pain with the correct approachFoam rolled it. Stretched it. Maybe even tried a cortisone shot. And that outer knee pain just keeps coming back? 🦵In this episode, ...

13 Heinä 11min

#80. The 8 Most Commonly Taught Topics from a Doctor of Physical Therapy

This episode started as a rapid-fire TikTok I filmed while meal prepping — it's since crossed 265,000 views. So many of you asked me to explain each point instead of rattling them off in under a minut...

6 Heinä 9min

#79. Why Women Lose Strength, Muscle, and Mobility in Menopause — and how to fight back ft. Madi Jenkins (Re-Run)

The medical system rarely has a good answer for what menopause does to your muscles, joints, and bones. Madi Jenkins does.In the episode 79, Dr. Clayton Dir, PT, DPT sits down with Madi Jenkins — powe...

29 Kesä 41min

#78. The Longest Study in Human History Found the #1 Key to Longevity — It's Not What You Think

What if the most powerful longevity intervention isn't something you order online — but someone you connect with?I just got back from 4 days at the lake with my family. No cell service. No work. Just ...

22 Kesä 8min

#77. Heel Pain: Why Injections, Orthotics & Stretching Aren't Fixing It | Plantar Fasciitis Myths Debunked with Dr. Allison Bullinger PT, DPT

If you've had heel pain for months — or years — and nothing has worked, this episode might explain why.Here's a stat that surprises almost everyone: only about 5% of people who walk into the clinic co...

15 Kesä 13min

#75. Before You Schedule Shoulder Surgery — Listen to This

If someone sent you this episode, it's because they care about you and want you to know that surgery is not your only option.If you found it yourself — you're already asking the right questions.Most s...

1 Kesä 15min