September 3, 2026 • 28 mins
On this Salcedo Storm Podcast:
Dr. Carrie de Moor is a board-certified emergency physician, healthcare executive, and founder of Driven Healthcare, an independent Texas medical practice.
Dr. Carrie de Moor is a board-certified emergency physician, healthcare executive, and founder of Driven Healthcare, an independent Texas medical practice.
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Speaker 1 (00:04):
And 84% of Americans want the Save America Act!
Speaker 2 (00:12):
But anybody who follows this process closely knows that we
don't have the votes.
Speaker 3 (00:15):
You tried your best, and you failed miserably.
Speaker 4 (00:18):
The lesson is, never try.
Speaker 5 (00:21):
The proof that you mailed your ballot on or just
before election day, it's not just a postmark, you can
handwrite the date.
Speaker 6 (00:29):
Wow.
Speaker 5 (00:30):
And that.
Speaker 4 (00:31):
This is this horrible thing to say about.
Speaker 3 (00:33):
They will remove 25 million people off the road.
Speaker 2 (00:36):
Ha ha ha ha ha ha ha! Shut up!
Speaker 4 (00:39):
This is our Signal Storm podcast.
Speaker 2 (01:09):
So I'm sitting there the other day watching the latest
offering from Taylor Sheridan on streaming. Taylor Sheridan, for those
of you who don't know, he was the guy behind
Yellowstone and has since cranked out hit after hit after
hit after hit. And one of his current offerings is
a program called Lioness. And it's about a secret organization
(01:34):
inside the U.S. government that basically conscripts beautiful women, highly
trained women, to conduct intelligence gatherings, surveillance, and sometimes even
combat situations. Anyway, so one of the main characters, a
woman by the name of Jo, played by Zo, I
(01:55):
believe her last name is pronounced Zeldanya. Anyway, she's the
same individual who played Ohura in the new Star Trek reboot,
and also played Gamora in Guardians of the Galaxy. She
was the green lady, right? That's the actress. She plays
the lead in this. And her husband is a medical doctor.
(02:17):
And she comes home after a particularly excruciating day and
says to him, how was your day? He says, well,
I diagnosed a 10-year-old with colon cancer, stage 3 colon cancer.
And I was like, Well, wait a minute. I know
how Taylor Sheridan likes to write, you know, to the headlines.
(02:38):
I go, is that a thing? And well, according to
a lot of the journals out there, yes, it is.
This is from, what is this? ONS. That's, hold on
a minute. What does this stand for? The Oncology, the
Home for Oncology Nurses. So these folks are the cancer nurses, okay?
(03:04):
So this article came up. Kids as young as 10
see up to 500% increase in colorectal cancer diagnoses. Confounding
researchers and clinicians alike, colorectal cancer rates are dramatically increasing
among younger populations. The latest study results published in the gastrointestinal,
(03:25):
or gastro, oh boy, these medical terms, Gastroenterology. Researchers quantified
the drastic shift of colorectal cancer diagnoses in various young
groups aged 10 to 24. Using information from the U.S.
(03:47):
Centers for Disease Control and Prevention, Wonder Database, the researchers
evaluated colorectal cancer incidence trends From 1999 to 2020, in
patients aged 10 to 44. During the 22-year study period,
colorectal cancer diagnoses increased by 500% among patients aged 10
to 14, 333% among patients aged 15 to 19, 185%
(04:11):
among patients aged 20 to 24. Folks, this is incredibly alarming. Now,
I talked to a couple of medical professionals about this,
and one of them offered me this. that when there's
childhood obesity at the rate at which it's happening, that
could tend to be a contributing factor to the increased
(04:33):
diagnoses of colorectal cancer. They say that obesity at any
age is actually a contributing factor. I think you double
your chance of colorectal cancer when you are obese, and
that goes for adults as well. So because so many
of our children are sorry, obese is the reason why
(04:54):
we may, may be seeing an increased incidence of colorectal
cancer diagnoses. There's another explanation. This was published by the
University of California, San Diego. In an effort to explain
a modern medical mystery, an internal team of researchers led
by the University of California, San Diego has identified a
(05:16):
potential microbial culprit in behind the alarming rise in early-onset
colorectal cancer, a bacterial toxin called colibactin, produced by certain
strains of, oh boy, Escherichia E. coli, basically it's E. coli,
that reside in the colon and return. Colibactin is a
(05:40):
toxin capable of altering DNA. Now scientists report that exposure
to colibactin in early childhood imprints a distinct genetic signature
on the DNA of the colon cells, one that may
increase the risk of developing colorectal cancer before the age
of 50. The new study published in April in the
(06:05):
publication Nature analyzed 981 colorectal cancer genomes from patients with
both early and late-onset disease across 11 countries with varying
colorectal cancer risk levels. The findings show that colibactin leaves
(06:31):
behind specific patterns of DNA mutations that were 3.3 times
more common in early-onset cases, specifically in adults under 40,
than in those diagnosed after the age of 70. These
mutation patterns were also particularly prevalent in countries with high
incidence of early onset cases. So there's that, there's the
(06:56):
obesity in the diet, and there's also what we're eating.
There's a new emphasis, and I'm glad to see it,
on getting us away from processed foods, getting us away
from candies, getting processed candies, getting us away from food
that has to be, that is bleached or subjected to chemicals.
(07:19):
I can't speak for everybody out there, but I've been
partaking in a lot of nuts, a lot of raisins,
freeze-dried fruits, that kind of thing, as my snacking. And
I'm not going to say it's a miracle drug, folks,
but I sure feel a hell of a lot better.
So maybe there's something to this. Now, I can tell
(07:41):
you we are not going to solve any of these problems, folks,
with socialized medicine that is Obamacare. And we're not going
to be solving these problems, folks, by giving all of
our money away to the traitorous insurance companies. I have
a story about what the traitorous insurance companies are up
to that is a direct threat to you getting the
(08:04):
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way next on the Salcedo Storm Podcast. Are you sick
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Speaker 2 (11:36):
My friends, I think this is going to be the
Salcedo Storm podcast that you take note of. Maybe even
decide to share it with an elected official of your choice.
And I want you to hear what's being alleged.
Speaker 3 (11:49):
Dr.
Speaker 2 (11:50):
Kerry Damore, folks, is a board-certified emergency physician healthcare executive
and founder of Driven Healthcare, an independent Texas medical practice. Doctor,
welcome to the Salcedo Show.
Speaker 4 (12:00):
Thank you. Thanks for having me. All right.
Speaker 2 (12:03):
Blue Cross and Blue Shield of Texas has allegedly instituted
something called systematic downcoding. What is that and what does
it mean to practices?
Speaker 4 (12:16):
So basically what they're doing is when you get seen
by your doctor or Say the work that the doctor does,
it takes an amount of time and that gets assigned
a code and that's how your doctor gets paid, right?
And so say you spend a certain amount of time
or they put in a certain amount of work for
you to take care of you and they have a
(12:37):
certain amount of medical decision making, you assign a code
to that. Most codes are going to fall in like
this level four moderate kind of complexity code Some are
going to fall into more rarely, but some are going
to fall into a level five, which is a high
complexity code. And so what they're doing is they are
(12:57):
essentially everything. If we turn in a four or a five,
they're making it a three, every single one without reason.
And they started doing this on July 1st. So we
submit a claim for you and the claim pops back
and instead of getting paid for the work that we
(13:18):
did at a level four or five, they're saying, no,
we're just going to pay you for what we think
we should pay you for this. And at a level
three or level four, which is not the work you
already did. Right. And then on top of it, it's
creating even more work for your doctor because then we're
having to go and appeal that claim so that we
(13:40):
can be appropriately reimbursed.
Speaker 2 (13:42):
Okay.
Speaker 3 (13:42):
All right.
Speaker 2 (13:43):
So folks, Let me just go through this because just
so you understand, you have health insurance, which is really
not insurance, folks. Insurance is when you take out a
policy against a loss and then when the loss happens,
you get reimbursed by the insurance company. What this thing
is that they call health insurance is just basically cost spreading, right?
(14:06):
To make these insurance companies filthy rich, the very same
insurance companies who colluded against you and spent a whole
bunch of money on Obamacare, forcing Obamacare down our throats.
So what's being alleged here is that Blue Cross Blue
Shield is coming in, and let's say you have Blue
Cross Blue Shield as your quote-unquote insurance company. You go
(14:28):
in and you get a physical, right? You get a physical,
and it's a level five physical. I mean, you had
to do a whole bunch of stuff done, right? And
then your doctor says, okay, I performed a level five physical.
I did the work, so now let me bill the
health insurance company, Blue Cross, Blue Cross Blue Shield reimburses
for a level three.
Speaker 4 (14:50):
Dr.
Speaker 2 (14:50):
DeMore, first off, how are they, they're doing it on
every single order. Number one, how are they doing that?
That takes a lot of manpower, doesn't it?
Speaker 4 (14:59):
Well, you know, that's one of the questions that we'd
like for Blue Cross Blue Shield to answer that question.
How are you doing this? According to their own policy,
They're supposed to be going through a process of a
review process. Well, these claims, you know, that come back
are coming back so rapidly that it's hard to imagine
(15:22):
that humans could be actually performing that function.
Speaker 1 (15:26):
So the concern is, is there, you know, AI involved
in these auto, what I would call auto denial or
auto down codes.
Speaker 2 (15:37):
Right. So the downcoding is happening, folks, universally. Anytime somebody
in Texas submits, the reimbursement comes back. And as you
heard Dr. Namur say, then the doctor's office, maybe you
belong to a mom and pop or a small doctor's
office that hasn't joined one of these mega conglomerates, they've
got to go through the extra expense and time. And
(15:59):
for all their Blue Cross patients, they have to resubmit
an appeal to get the money that they are owed. Now,
Did the doctor's offices receive notice from Blue Cross Blue Shield, Dr. Namur,
that this was going to be happening?
Speaker 4 (16:12):
There was a notice that was put out in like
a little newsletter in March that they were going to
implement a new claim review procedure. However, that this would
happen on every claim that this would be, hey, you're
going to need to bulk up your staff a little
bit there because you're going to have to appeal 100
(16:33):
claims a week. That was not in the notice that
this was going to be automated. It was supposed to
be done based on the mechanism of which they claimed
in their policy, which is about 10 sentences long. I mean,
not even. It's very small. And so, you know, this way,
at this point in time, trying to demand answers from them,
(16:54):
how are you doing it? Why are you doing it?
And how does this seem to comply with what you
told us you were going to do?
Speaker 2 (17:01):
Well, let me let me ask you, because, you know,
I mentioned the conglomerates like Baylor, Scott and White and
all these these conglomerates that are they're gobbling up small
practices everywhere and gobbling up medical professionals in the process.
Are they getting the same universal down coding imposed on them?
Speaker 4 (17:20):
I highly doubt that that is occurring. I don't work
for them, so I don't necessarily see it directly. However,
I am a member as well of Blue Cross and
my daughter happened to have, she broke her arm playing
soccer back about a month ago. And so we've had
an office visit and I've seen the return of those
claims come back from similar, you know, types of visits. And,
(17:46):
They seem to be doing quite well without any kind
of cut in their reimbursement or delay in being paid
an appropriate amount.
Speaker 2 (17:56):
I see.
Speaker 4 (17:57):
So I think this is very targeted to independent practices.
Speaker 6 (18:02):
Dr.
Speaker 2 (18:02):
Carrie DeMore is board-certified emergency physician, folks, healthcare executive, and
founder of Driven Healthcare. So that leads into my next question.
Let me just take your small practice because you are
reflective of a dying breed. of small doctor's offices that
serve the community that are being gobbled up, as I mentioned,
by these massive conglomerates because the small businesses can't survive
(18:26):
on their own. If you were to hire somebody just
to handle the Blue Cross Blue Shield, because you got
to know if one is successful and gets away with it,
all the rest of them are going to start downcoding
as well. How much would it cost you to hire
a person And that's all they do is appeal all
of these down-coded claims. Number one, how much would it
(18:47):
cost you and can you afford it as a small practice?
Speaker 4 (18:50):
At minimum, I'm probably hiring somebody for $ 20 an hour
at least. It's going to take me time to actually
get them to understand what to do. The problem is
with even hiring out other people to do this is
that They're asking you to appeal in such a way
that you do medical decision making. So somebody actually has
(19:12):
to understand why you're right as a physician. So I
know myself and many other individual practitioners are really doing
these appeals individually. And I know I am. And it
is so cost prohibitive and so time consuming. It's overwhelming.
I talked to another provider last night. She said, I
(19:33):
just finished 60 appeals. And she's like, this isn't sustainable.
And I'm like, I know. I'm actually preparing to cut
hours and time from the jobs of people who work
for me now because we can't stay open and work.
to do that with our reimbursement being cut, which essentially
(19:53):
ends up being at about 30 to 40 percent of
our income overnight.
Speaker 2 (19:57):
Wow. 30 to 40 percent of your income. And of course, folks,
how does this directly impact you as patients of these
doctors here in Texas? It directly impacts your ability to
access health care. and to access these doctors because they're
having to reduce staff, reduce hours, quality of care goes down,
and ultimately the doctor maybe you've been seeing for decades
(20:18):
has to close shop. What do you think the goal
is of what I call the traitorous insurance companies because
of what they did to us with Obamacare, Dr.
Speaker 1 (20:29):
Damore?
Speaker 2 (20:29):
What do you think their goal is with this alleged
universal down-coding?
Speaker 4 (20:35):
There is no question in my mind that this is about,
number one, control. They do not want us in business.
They don't want independent doctors. They don't want the independent
physician who's going to look at you as an individual person,
who's going to make the decision that we can with
independent medical decision-making. They want to control it. When they
control the purse strings of your health care, they control you.
(20:59):
And it is 100% about control and wanting to eliminate...
the independent practice of medicine. They have been on this
path for a long time, and this, to me, is
one of the final blows they're trying in order to
get rid of what's very much left. I will say this,
back about before Obamacare, the independent practice of medicine in
Texas was what thrived. We had over 80% of non-employed physicians.
(21:24):
We're down, it's basically flipped at this point. I think
we're down to about 50%. 20 to even, if max,
30% of physicians are actually independent and not employed by
either a health insurance company, a big system, or a
private equity company. So something huge to keep in mind
about what that means for patients and not only their access,
(21:45):
but the individualized care that isn't being influenced by the
desire of a big corporation.
Speaker 2 (21:53):
Right. When you become not a patient, but you become
a number... So what's the net result if if the
political class in Texas doesn't do anything? And I can
imagine Texas isn't the only state this is happening. If
politicians don't address this universal downcoding, what if it's being
(22:14):
done as you describe? And it sounds to me like
no human being could do it. So it's it's likely
some sort of automated system or artificial intelligence is doing it.
What will health care look like in Texas? What will
health care look like in other states if this practice
goes unchallenged as of the next couple of months or
(22:35):
next couple of years?
Speaker 4 (22:38):
Well, I think, you know, you'll start to see the
closure of more and more independent practices, and there's always
the option for direct primary care. You pay cash, but Again,
most people get their insurance from their company, so they
want to use insurance, right? So what's going to happen
as you close these small businesses, number one, healthcare costs
(22:59):
are going to continue to just spike out of control because,
believe it or not, the independent guys are actually cheaper.
Speaker 5 (23:05):
Yes.
Speaker 4 (23:05):
We actually cost less.
Speaker 2 (23:07):
Yes.
Speaker 4 (23:07):
Almost all of the time than these big conglomerates and
these big systems. And so when we are eliminated, that
competition for making it cheaper... drastically drops off. There will
be no guardrails on keeping things competitive. It will not
be a free market. And I think that's going to
be the number one thing, your costs. You think it's
(23:29):
bad now, it's going to keep going up. And the
other thing is you're going to see medical decisions becoming
more like a universal healthcare kind of system. It's going
to be, this is our protocol. This is what we
believe in. We think that For example, if you wanted
to trial ivermectin, you're not getting ivermectin, right? Like with COVID,
(23:49):
you're not going to find a physician who's going to
be allowed to practice medicine independently. They're going to be
at the disposal of their company. They're going to be
basically providing what I would call the corporate practice of medicine,
which we actually do have laws against.
Speaker 2 (24:05):
Well, that's a great point.
Speaker 4 (24:07):
Hold on.
Speaker 2 (24:07):
Don't let that point go away. Folks, imagine we have
another pandemic or imagine we have another health crisis. issue
in this country. And the best practices are discovered, you know, ivermectin, hydroxychloroquine,
which are cheap, inexpensive, award-winning medications, which were poo-pooed by
the medical establishment and the China virus, which they were
(24:28):
done so falsely to promote remdesivir and of course the
experimental gene therapy they called a vaccine, which ended up
bringing a great deal of harm to patients. If you
look at the VAERS reports, So imagine your doctor saying, look,
I'd like to be able to prescribe you hydroxychloroquine or ivermectin,
(24:52):
but because of where I work, I can't do that
for you, even though I believe that's the best thing
for you. And then you say, well, fine, I'm just
going to go find another doctor. guess what? There is
no other independent doctor. They're all swallowed up by corporate entities,
all swallowed up by individuals who say, when we tell
you you can't take ivermectin, you won't be able to
(25:13):
take ivermectin wherever the hell you want to go. And Dr. Damore,
that's tyranny. That's dangerous to Americans and Texans' health, no?
Speaker 4 (25:23):
A hundred percent. And that's one of my biggest concerns
that I feel like I've been you know, kind of
crying this from the mountaintop for years since they started
a lot down this Obamacare path and just, you know,
that this is about control and it is about control
of your healthcare and they're going to decide, it's not
only that with ivermectin, They're going to decide, Chris, who lives.
Speaker 6 (25:45):
Who dies.
Speaker 4 (25:45):
They're going to decide, do you meet this criteria? They're
going to decide it all.
Speaker 2 (25:51):
I remember during the Obamacare debate, the death panels, that
Barack Obama, let me be clear, no death panels exist.
Guess what? They existed. That they're out there. This is
government telling you who gets to live and who gets
to die. Obama saying, yeah, you know what? Instead of
getting that knee replacement, we're just going to pump you
full of meds and let you manage your decline. That's
(26:13):
because it's less expensive. You become a dollar figure instead
of a patient. And this is the vision that they have.
Universal government controlled health care, folks. And and right now,
the traitorous insurance companies seem to be ushering that in.
Speaker 4 (26:27):
Dr.
Speaker 2 (26:27):
Carrie DeMore, board-certified emergency physician, healthcare executive, and founder of
Driven Healthcare. If folks want to get more information from you,
maybe learn about your practice and understand why they got
to call up their legislators to stop this alleged practice
of downcoding, where can they go?
Speaker 6 (26:45):
So the easiest way to follow things with policy with
me will be on my ex-account at cdemoremd.com. But also
my website for my clinic is drivenhealthcare.com. But I really
highly recommend following me on X to follow up with
this ongoing battle and other insurance battles that are going on.
Speaker 2 (27:06):
Dr. DeMore, we're going to be putting the interview up
on the YouTube channel a little bit later on this morning.
So folks will have this to share around with their legislators,
with their friends and family. And while we still have
a choice, I think it's incumbent upon us to fight back. Dr.
Carrie DeMore, thank you for your time and sounding the
alarm on this.
Speaker 4 (27:24):
Thank you for having me. I really appreciate it.
Speaker 2 (27:26):
And with that, we call it a podcast, folks, a
Salcedo Storm podcast. Till we visit again, there's a couple
of things I want you to remember.
Speaker 5 (27:32):
First.
Speaker 2 (27:33):
Pick up the new book, The Rise of the Liberty
Loving Latino, A New American Revolution. You can pick it
up in hard copy form or in audio book form.
They've got it at Amazon. The audio book, of course,
available through their Audible application slash download. That's how I
get all of my books anyway, through Audible.com. because I'm
(27:54):
usually multitasking and trying to listen and do, do multiple
things like working out or what have you. So it's
a great way to, to, to have me along. You
can also take me along in the car and your commute,
driving the kids to school and listen to the book
that way. The rise of the Liberty loving Latino and
new American revolution. Also remember this, a society's worth is
not measured by how much power stolen by an out
(28:16):
of control government, a society's worth, meaning its values. is
measured by how much power is reserved for you and me,
we the people. You keep fighting to save your country
out there, my friends, because the United States is worth it.
And 84% of Americans want the Save America Act!
Speaker 2 (00:12):
But anybody who follows this process closely knows that we
don't have the votes.
Speaker 3 (00:15):
You tried your best, and you failed miserably.
Speaker 4 (00:18):
The lesson is, never try.
Speaker 5 (00:21):
The proof that you mailed your ballot on or just
before election day, it's not just a postmark, you can
handwrite the date.
Speaker 6 (00:29):
Wow.
Speaker 5 (00:30):
And that.
Speaker 4 (00:31):
This is this horrible thing to say about.
Speaker 3 (00:33):
They will remove 25 million people off the road.
Speaker 2 (00:36):
Ha ha ha ha ha ha ha! Shut up!
Speaker 4 (00:39):
This is our Signal Storm podcast.
Speaker 2 (01:09):
So I'm sitting there the other day watching the latest
offering from Taylor Sheridan on streaming. Taylor Sheridan, for those
of you who don't know, he was the guy behind
Yellowstone and has since cranked out hit after hit after
hit after hit. And one of his current offerings is
a program called Lioness. And it's about a secret organization
(01:34):
inside the U.S. government that basically conscripts beautiful women, highly
trained women, to conduct intelligence gatherings, surveillance, and sometimes even
combat situations. Anyway, so one of the main characters, a
woman by the name of Jo, played by Zo, I
(01:55):
believe her last name is pronounced Zeldanya. Anyway, she's the
same individual who played Ohura in the new Star Trek reboot,
and also played Gamora in Guardians of the Galaxy. She
was the green lady, right? That's the actress. She plays
the lead in this. And her husband is a medical doctor.
(02:17):
And she comes home after a particularly excruciating day and
says to him, how was your day? He says, well,
I diagnosed a 10-year-old with colon cancer, stage 3 colon cancer.
And I was like, Well, wait a minute. I know
how Taylor Sheridan likes to write, you know, to the headlines.
(02:38):
I go, is that a thing? And well, according to
a lot of the journals out there, yes, it is.
This is from, what is this? ONS. That's, hold on
a minute. What does this stand for? The Oncology, the
Home for Oncology Nurses. So these folks are the cancer nurses, okay?
(03:04):
So this article came up. Kids as young as 10
see up to 500% increase in colorectal cancer diagnoses. Confounding
researchers and clinicians alike, colorectal cancer rates are dramatically increasing
among younger populations. The latest study results published in the gastrointestinal,
(03:25):
or gastro, oh boy, these medical terms, Gastroenterology. Researchers quantified
the drastic shift of colorectal cancer diagnoses in various young
groups aged 10 to 24. Using information from the U.S.
(03:47):
Centers for Disease Control and Prevention, Wonder Database, the researchers
evaluated colorectal cancer incidence trends From 1999 to 2020, in
patients aged 10 to 44. During the 22-year study period,
colorectal cancer diagnoses increased by 500% among patients aged 10
to 14, 333% among patients aged 15 to 19, 185%
(04:11):
among patients aged 20 to 24. Folks, this is incredibly alarming. Now,
I talked to a couple of medical professionals about this,
and one of them offered me this. that when there's
childhood obesity at the rate at which it's happening, that
could tend to be a contributing factor to the increased
(04:33):
diagnoses of colorectal cancer. They say that obesity at any
age is actually a contributing factor. I think you double
your chance of colorectal cancer when you are obese, and
that goes for adults as well. So because so many
of our children are sorry, obese is the reason why
(04:54):
we may, may be seeing an increased incidence of colorectal
cancer diagnoses. There's another explanation. This was published by the
University of California, San Diego. In an effort to explain
a modern medical mystery, an internal team of researchers led
by the University of California, San Diego has identified a
(05:16):
potential microbial culprit in behind the alarming rise in early-onset
colorectal cancer, a bacterial toxin called colibactin, produced by certain
strains of, oh boy, Escherichia E. coli, basically it's E. coli,
that reside in the colon and return. Colibactin is a
(05:40):
toxin capable of altering DNA. Now scientists report that exposure
to colibactin in early childhood imprints a distinct genetic signature
on the DNA of the colon cells, one that may
increase the risk of developing colorectal cancer before the age
of 50. The new study published in April in the
(06:05):
publication Nature analyzed 981 colorectal cancer genomes from patients with
both early and late-onset disease across 11 countries with varying
colorectal cancer risk levels. The findings show that colibactin leaves
(06:31):
behind specific patterns of DNA mutations that were 3.3 times
more common in early-onset cases, specifically in adults under 40,
than in those diagnosed after the age of 70. These
mutation patterns were also particularly prevalent in countries with high
incidence of early onset cases. So there's that, there's the
(06:56):
obesity in the diet, and there's also what we're eating.
There's a new emphasis, and I'm glad to see it,
on getting us away from processed foods, getting us away
from candies, getting processed candies, getting us away from food
that has to be, that is bleached or subjected to chemicals.
(07:19):
I can't speak for everybody out there, but I've been
partaking in a lot of nuts, a lot of raisins,
freeze-dried fruits, that kind of thing, as my snacking. And
I'm not going to say it's a miracle drug, folks,
but I sure feel a hell of a lot better.
So maybe there's something to this. Now, I can tell
(07:41):
you we are not going to solve any of these problems, folks,
with socialized medicine that is Obamacare. And we're not going
to be solving these problems, folks, by giving all of
our money away to the traitorous insurance companies. I have
a story about what the traitorous insurance companies are up
to that is a direct threat to you getting the
(08:04):
care you need in the medical community. That comes your
way next on the Salcedo Storm Podcast. Are you sick
of all these Medicare commercials? Well, what if you're under
65 and need quality, affordable health coverage? American Medical Plan
specializes in under 65 health insurance plans that have zero
co-pays at the doctor and no deductible on all outpatient services,
(08:25):
including surgeries. You pick your doctors and hospitals. There are
private plans, enroll anytime, and they are 30 to 60%
less than Obamacare. If you're paying too much for your
own health insurance, call American Medical Plans. They will customize
a plan managed and chosen by you, not the government.
Chris Salcedo.
Speaker 5 (08:43):
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(10:16):
win and you'll never sleep better.
Speaker 2 (10:21):
Chris Salcedo. Do you support the sanctity of life? Our military,
our veterans, our first responders? Well, so does Patriot Mobile.
They have great discounts for all of those folks, plus
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Speaker 3 (11:22):
The establishment media is out of touch with the real
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That's what Texas Scorecard does every day. Learn more and
subscribe for free. TexasScorecard.com slash Chris.
Speaker 2 (11:36):
My friends, I think this is going to be the
Salcedo Storm podcast that you take note of. Maybe even
decide to share it with an elected official of your choice.
And I want you to hear what's being alleged.
Speaker 3 (11:49):
Dr.
Speaker 2 (11:50):
Kerry Damore, folks, is a board-certified emergency physician healthcare executive
and founder of Driven Healthcare, an independent Texas medical practice. Doctor,
welcome to the Salcedo Show.
Speaker 4 (12:00):
Thank you. Thanks for having me. All right.
Speaker 2 (12:03):
Blue Cross and Blue Shield of Texas has allegedly instituted
something called systematic downcoding. What is that and what does
it mean to practices?
Speaker 4 (12:16):
So basically what they're doing is when you get seen
by your doctor or Say the work that the doctor does,
it takes an amount of time and that gets assigned
a code and that's how your doctor gets paid, right?
And so say you spend a certain amount of time
or they put in a certain amount of work for
you to take care of you and they have a
(12:37):
certain amount of medical decision making, you assign a code
to that. Most codes are going to fall in like
this level four moderate kind of complexity code Some are
going to fall into more rarely, but some are going
to fall into a level five, which is a high
complexity code. And so what they're doing is they are
(12:57):
essentially everything. If we turn in a four or a five,
they're making it a three, every single one without reason.
And they started doing this on July 1st. So we
submit a claim for you and the claim pops back
and instead of getting paid for the work that we
(13:18):
did at a level four or five, they're saying, no,
we're just going to pay you for what we think
we should pay you for this. And at a level
three or level four, which is not the work you
already did. Right. And then on top of it, it's
creating even more work for your doctor because then we're
having to go and appeal that claim so that we
(13:40):
can be appropriately reimbursed.
Speaker 2 (13:42):
Okay.
Speaker 3 (13:42):
All right.
Speaker 2 (13:43):
So folks, Let me just go through this because just
so you understand, you have health insurance, which is really
not insurance, folks. Insurance is when you take out a
policy against a loss and then when the loss happens,
you get reimbursed by the insurance company. What this thing
is that they call health insurance is just basically cost spreading, right?
(14:06):
To make these insurance companies filthy rich, the very same
insurance companies who colluded against you and spent a whole
bunch of money on Obamacare, forcing Obamacare down our throats.
So what's being alleged here is that Blue Cross Blue
Shield is coming in, and let's say you have Blue
Cross Blue Shield as your quote-unquote insurance company. You go
(14:28):
in and you get a physical, right? You get a physical,
and it's a level five physical. I mean, you had
to do a whole bunch of stuff done, right? And
then your doctor says, okay, I performed a level five physical.
I did the work, so now let me bill the
health insurance company, Blue Cross, Blue Cross Blue Shield reimburses
for a level three.
Speaker 4 (14:50):
Dr.
Speaker 2 (14:50):
DeMore, first off, how are they, they're doing it on
every single order. Number one, how are they doing that?
That takes a lot of manpower, doesn't it?
Speaker 4 (14:59):
Well, you know, that's one of the questions that we'd
like for Blue Cross Blue Shield to answer that question.
How are you doing this? According to their own policy,
They're supposed to be going through a process of a
review process. Well, these claims, you know, that come back
are coming back so rapidly that it's hard to imagine
(15:22):
that humans could be actually performing that function.
Speaker 1 (15:26):
So the concern is, is there, you know, AI involved
in these auto, what I would call auto denial or
auto down codes.
Speaker 2 (15:37):
Right. So the downcoding is happening, folks, universally. Anytime somebody
in Texas submits, the reimbursement comes back. And as you
heard Dr. Namur say, then the doctor's office, maybe you
belong to a mom and pop or a small doctor's
office that hasn't joined one of these mega conglomerates, they've
got to go through the extra expense and time. And
(15:59):
for all their Blue Cross patients, they have to resubmit
an appeal to get the money that they are owed. Now,
Did the doctor's offices receive notice from Blue Cross Blue Shield, Dr. Namur,
that this was going to be happening?
Speaker 4 (16:12):
There was a notice that was put out in like
a little newsletter in March that they were going to
implement a new claim review procedure. However, that this would
happen on every claim that this would be, hey, you're
going to need to bulk up your staff a little
bit there because you're going to have to appeal 100
(16:33):
claims a week. That was not in the notice that
this was going to be automated. It was supposed to
be done based on the mechanism of which they claimed
in their policy, which is about 10 sentences long. I mean,
not even. It's very small. And so, you know, this way,
at this point in time, trying to demand answers from them,
(16:54):
how are you doing it? Why are you doing it?
And how does this seem to comply with what you
told us you were going to do?
Speaker 2 (17:01):
Well, let me let me ask you, because, you know,
I mentioned the conglomerates like Baylor, Scott and White and
all these these conglomerates that are they're gobbling up small
practices everywhere and gobbling up medical professionals in the process.
Are they getting the same universal down coding imposed on them?
Speaker 4 (17:20):
I highly doubt that that is occurring. I don't work
for them, so I don't necessarily see it directly. However,
I am a member as well of Blue Cross and
my daughter happened to have, she broke her arm playing
soccer back about a month ago. And so we've had
an office visit and I've seen the return of those
claims come back from similar, you know, types of visits. And,
(17:46):
They seem to be doing quite well without any kind
of cut in their reimbursement or delay in being paid
an appropriate amount.
Speaker 2 (17:56):
I see.
Speaker 4 (17:57):
So I think this is very targeted to independent practices.
Speaker 6 (18:02):
Dr.
Speaker 2 (18:02):
Carrie DeMore is board-certified emergency physician, folks, healthcare executive, and
founder of Driven Healthcare. So that leads into my next question.
Let me just take your small practice because you are
reflective of a dying breed. of small doctor's offices that
serve the community that are being gobbled up, as I mentioned,
by these massive conglomerates because the small businesses can't survive
(18:26):
on their own. If you were to hire somebody just
to handle the Blue Cross Blue Shield, because you got
to know if one is successful and gets away with it,
all the rest of them are going to start downcoding
as well. How much would it cost you to hire
a person And that's all they do is appeal all
of these down-coded claims. Number one, how much would it
(18:47):
cost you and can you afford it as a small practice?
Speaker 4 (18:50):
At minimum, I'm probably hiring somebody for $ 20 an hour
at least. It's going to take me time to actually
get them to understand what to do. The problem is
with even hiring out other people to do this is
that They're asking you to appeal in such a way
that you do medical decision making. So somebody actually has
(19:12):
to understand why you're right as a physician. So I
know myself and many other individual practitioners are really doing
these appeals individually. And I know I am. And it
is so cost prohibitive and so time consuming. It's overwhelming.
I talked to another provider last night. She said, I
(19:33):
just finished 60 appeals. And she's like, this isn't sustainable.
And I'm like, I know. I'm actually preparing to cut
hours and time from the jobs of people who work
for me now because we can't stay open and work.
to do that with our reimbursement being cut, which essentially
(19:53):
ends up being at about 30 to 40 percent of
our income overnight.
Speaker 2 (19:57):
Wow. 30 to 40 percent of your income. And of course, folks,
how does this directly impact you as patients of these
doctors here in Texas? It directly impacts your ability to
access health care. and to access these doctors because they're
having to reduce staff, reduce hours, quality of care goes down,
and ultimately the doctor maybe you've been seeing for decades
(20:18):
has to close shop. What do you think the goal
is of what I call the traitorous insurance companies because
of what they did to us with Obamacare, Dr.
Speaker 1 (20:29):
Damore?
Speaker 2 (20:29):
What do you think their goal is with this alleged
universal down-coding?
Speaker 4 (20:35):
There is no question in my mind that this is about,
number one, control. They do not want us in business.
They don't want independent doctors. They don't want the independent
physician who's going to look at you as an individual person,
who's going to make the decision that we can with
independent medical decision-making. They want to control it. When they
control the purse strings of your health care, they control you.
(20:59):
And it is 100% about control and wanting to eliminate...
the independent practice of medicine. They have been on this
path for a long time, and this, to me, is
one of the final blows they're trying in order to
get rid of what's very much left. I will say this,
back about before Obamacare, the independent practice of medicine in
Texas was what thrived. We had over 80% of non-employed physicians.
(21:24):
We're down, it's basically flipped at this point. I think
we're down to about 50%. 20 to even, if max,
30% of physicians are actually independent and not employed by
either a health insurance company, a big system, or a
private equity company. So something huge to keep in mind
about what that means for patients and not only their access,
(21:45):
but the individualized care that isn't being influenced by the
desire of a big corporation.
Speaker 2 (21:53):
Right. When you become not a patient, but you become
a number... So what's the net result if if the
political class in Texas doesn't do anything? And I can
imagine Texas isn't the only state this is happening. If
politicians don't address this universal downcoding, what if it's being
(22:14):
done as you describe? And it sounds to me like
no human being could do it. So it's it's likely
some sort of automated system or artificial intelligence is doing it.
What will health care look like in Texas? What will
health care look like in other states if this practice
goes unchallenged as of the next couple of months or
(22:35):
next couple of years?
Speaker 4 (22:38):
Well, I think, you know, you'll start to see the
closure of more and more independent practices, and there's always
the option for direct primary care. You pay cash, but Again,
most people get their insurance from their company, so they
want to use insurance, right? So what's going to happen
as you close these small businesses, number one, healthcare costs
(22:59):
are going to continue to just spike out of control because,
believe it or not, the independent guys are actually cheaper.
Speaker 5 (23:05):
Yes.
Speaker 4 (23:05):
We actually cost less.
Speaker 2 (23:07):
Yes.
Speaker 4 (23:07):
Almost all of the time than these big conglomerates and
these big systems. And so when we are eliminated, that
competition for making it cheaper... drastically drops off. There will
be no guardrails on keeping things competitive. It will not
be a free market. And I think that's going to
be the number one thing, your costs. You think it's
(23:29):
bad now, it's going to keep going up. And the
other thing is you're going to see medical decisions becoming
more like a universal healthcare kind of system. It's going
to be, this is our protocol. This is what we
believe in. We think that For example, if you wanted
to trial ivermectin, you're not getting ivermectin, right? Like with COVID,
(23:49):
you're not going to find a physician who's going to
be allowed to practice medicine independently. They're going to be
at the disposal of their company. They're going to be
basically providing what I would call the corporate practice of medicine,
which we actually do have laws against.
Speaker 2 (24:05):
Well, that's a great point.
Speaker 4 (24:07):
Hold on.
Speaker 2 (24:07):
Don't let that point go away. Folks, imagine we have
another pandemic or imagine we have another health crisis. issue
in this country. And the best practices are discovered, you know, ivermectin, hydroxychloroquine,
which are cheap, inexpensive, award-winning medications, which were poo-pooed by
the medical establishment and the China virus, which they were
(24:28):
done so falsely to promote remdesivir and of course the
experimental gene therapy they called a vaccine, which ended up
bringing a great deal of harm to patients. If you
look at the VAERS reports, So imagine your doctor saying, look,
I'd like to be able to prescribe you hydroxychloroquine or ivermectin,
(24:52):
but because of where I work, I can't do that
for you, even though I believe that's the best thing
for you. And then you say, well, fine, I'm just
going to go find another doctor. guess what? There is
no other independent doctor. They're all swallowed up by corporate entities,
all swallowed up by individuals who say, when we tell
you you can't take ivermectin, you won't be able to
(25:13):
take ivermectin wherever the hell you want to go. And Dr. Damore,
that's tyranny. That's dangerous to Americans and Texans' health, no?
Speaker 4 (25:23):
A hundred percent. And that's one of my biggest concerns
that I feel like I've been you know, kind of
crying this from the mountaintop for years since they started
a lot down this Obamacare path and just, you know,
that this is about control and it is about control
of your healthcare and they're going to decide, it's not
only that with ivermectin, They're going to decide, Chris, who lives.
Speaker 6 (25:45):
Who dies.
Speaker 4 (25:45):
They're going to decide, do you meet this criteria? They're
going to decide it all.
Speaker 2 (25:51):
I remember during the Obamacare debate, the death panels, that
Barack Obama, let me be clear, no death panels exist.
Guess what? They existed. That they're out there. This is
government telling you who gets to live and who gets
to die. Obama saying, yeah, you know what? Instead of
getting that knee replacement, we're just going to pump you
full of meds and let you manage your decline. That's
(26:13):
because it's less expensive. You become a dollar figure instead
of a patient. And this is the vision that they have.
Universal government controlled health care, folks. And and right now,
the traitorous insurance companies seem to be ushering that in.
Speaker 4 (26:27):
Dr.
Speaker 2 (26:27):
Carrie DeMore, board-certified emergency physician, healthcare executive, and founder of
Driven Healthcare. If folks want to get more information from you,
maybe learn about your practice and understand why they got
to call up their legislators to stop this alleged practice
of downcoding, where can they go?
Speaker 6 (26:45):
So the easiest way to follow things with policy with
me will be on my ex-account at cdemoremd.com. But also
my website for my clinic is drivenhealthcare.com. But I really
highly recommend following me on X to follow up with
this ongoing battle and other insurance battles that are going on.
Speaker 2 (27:06):
Dr. DeMore, we're going to be putting the interview up
on the YouTube channel a little bit later on this morning.
So folks will have this to share around with their legislators,
with their friends and family. And while we still have
a choice, I think it's incumbent upon us to fight back. Dr.
Carrie DeMore, thank you for your time and sounding the
alarm on this.
Speaker 4 (27:24):
Thank you for having me. I really appreciate it.
Speaker 2 (27:26):
And with that, we call it a podcast, folks, a
Salcedo Storm podcast. Till we visit again, there's a couple
of things I want you to remember.
Speaker 5 (27:32):
First.
Speaker 2 (27:33):
Pick up the new book, The Rise of the Liberty
Loving Latino, A New American Revolution. You can pick it
up in hard copy form or in audio book form.
They've got it at Amazon. The audio book, of course,
available through their Audible application slash download. That's how I
get all of my books anyway, through Audible.com. because I'm
(27:54):
usually multitasking and trying to listen and do, do multiple
things like working out or what have you. So it's
a great way to, to, to have me along. You
can also take me along in the car and your commute,
driving the kids to school and listen to the book
that way. The rise of the Liberty loving Latino and
new American revolution. Also remember this, a society's worth is
not measured by how much power stolen by an out
(28:16):
of control government, a society's worth, meaning its values. is
measured by how much power is reserved for you and me,
we the people. You keep fighting to save your country
out there, my friends, because the United States is worth it.
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