The algorithm?
If claim then reject;
this post was submitted on 26 Jul 2023
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Insurance has to be among the most corrupt and evil industries in the world.
Health insurance especially - every other type of insurance is for things that you don't expect to happen. People can go their whole life without a car crash. Not so much for medical care.
i cannot comprehend how we let for-profit health insurance be a thing... these people literally only profit at the expense of human health. there is no further reduction.
profit from human suffering, and it employs millions of people. and the icing is, they make it seem like a 'benefit'.
They've done a good job convincing a lot of people in this country that government is incompetent/inefficient/nefarious in running public services and that private companies provide better services and will keep costs down via competition and lack of regulation. It's totally working, guys!
and that private companies provide better services and will keep costs down via competition and lack of regulation.
And reality is actually the opposite. Take Medicare Advantage plans. They cost the government more money than regular Medicare. And they are worse for consumers, because they have been found to deny 18% of claims they should have approved and that regular Medicare would have approved.
cigna balls lol
(fuck insurance companies)
My wife and I may be part of this. They denied her 2 week hospital stay for preeclampsia and subsequent delivery as “unnecessary” and we foot the bill for the $17k stay
Whats crazy is the providers show no incentive to try and get it through. The insurnace pays so little vs the billed amount that as long as they can get you to pay more than a tenth of the amount they get more.
Is this not fraud if it wasn't actually reviewed by a doctor?
Although a doctor would be required to sign-off on the decision, their doctor simply reviews what the computer says So the doctor doesn't actually look at your individual case file like he should, he just rubberstamps in bulk all decisions spit out of the computer. So they will claim that they stay within the letter of the law by having a doctor "sign-off" on your decision, but in reality the doctor rubberstamps thousands of computer decisions all at once.