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How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them—USA
Isn’t that something that’s been going on for years?
rvallee
Senior Member (Voting Rights)
This system doesn't work without complicit doctors. Unless those doctors are disciplined, it's basically condoning the practice.
It's easy to blame greed, and it should, but none of this works without the complicity of people who think nothing of spending 2 seconds to click and deny. They even have quotes from doctors saying how it was so easy to do it.
It wouldn't be easy to do this if there were consequences. And unless there are consequences, this is acceptable medically acceptable. I don't expect any consequences, to be honest.
It's easy to blame greed, and it should, but none of this works without the complicity of people who think nothing of spending 2 seconds to click and deny. They even have quotes from doctors saying how it was so easy to do it.
It wouldn't be easy to do this if there were consequences. And unless there are consequences, this is acceptable medically acceptable. I don't expect any consequences, to be honest.
RedFox
Senior Member (Voting Rights)
I don't understand the point of health insurance if they can just deny stuff after the fact. Hearing all these horror stories, I feel relieved I never had private insurance. (Medicaid then Medicare)
ProPublica suggested another article with a similar theme: UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings.
It was interesting because the person in the article had a similar level of disability as someone with ME. Due to ulcerative colitis he was basically homebound.
ProPublica suggested another article with a similar theme: UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings.
It was interesting because the person in the article had a similar level of disability as someone with ME. Due to ulcerative colitis he was basically homebound.
That's another point, which applies to all kinds of other services and tactics used to make entitlement to rights not possible for those who are most ill or vulnerable.
In law there should really be a requirement that if someone does get to the end and something is overturned then the compensation can be huge if someone was utterly disabled or made further disabled by the 'size of fight' said organisation made them have unnecessarily.
The only way people will be put off using the jump-through-hoops to basically treat the most deserving as low-hanging fruit by pushing the buttons of their energy and health limitations is if the fine/consequences at the end are far far bigger than the money saved from all those who don't get to the end. As per everything else in life.
That should be seen as a deliberate form of not just discrimination but bullying and using tactics against someone's limitations that they know will affect them and not those who are less ill. And yes some of these things should probably have professional, reputational and criminal implications in order that the money balance doesn't just get remedied another way, people should be scared of losing their jobs, careers, freedom, if they do this or bully others into doing things like this or it happens under their watch and they cannot decisively prove that they did all they could to make sure it didn't (take away the pretend not to know being acceptable proof of 'I didn't know').