this post was submitted on 03 Jan 2025
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News

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[–] [email protected] 62 points 3 days ago
[–] [email protected] 52 points 3 days ago* (last edited 3 days ago) (1 children)

Wow, this is a whole lot of double speak.

UnitedHealthcare, which has not commented publicly on Levy's post, said in a press release on its website December 13: "UnitedHealthcare approves and pays about 90 percent of medical claims upon submission. Importantly, of those that require further review, around one-half of one percent are due to medical or clinical reasons. Highly inaccurate and grossly misleading information has been circulated about our company's treatment of insurance claims."

This is from 2023:

In their complaint, however, the families accuse UnitedHealth of using faulty AI to deny claims as part of a financial scheme to collect premiums without having to pay for coverage for elderly beneficiaries it believes lack the knowledge and resources "to appeal the erroneous AI-powered decisions."

UnitedHealth continues "to systemically deny claims using their flawed AI model because they know that only a tiny minority of policyholders (roughly 0.2%)1 will appeal denied claims, and the vast majority will either pay out-of-pocket costs or forgo the remainder of their prescribed post-acute care."

Source

[–] TipRing 56 points 3 days ago (2 children)

The "90% of medical claims" is such a weaselly metric. Yeah, if you have a small-cost claim like your annual physical or basic x-rays they pay, but if you need anything that costs money, that would push you over your deductible, they deny. Saying 90% just isn't meaningful if most claims are small-dollar.

[–] Webster 31 points 3 days ago (1 children)

Claim is also a later step in the process. The first step is prior authorization. So they could deny the prior auth that leads to work not being done which leads to no claim to count as a denial. Or a patient doesn't submit the claim because it had a denied prior auth, so again no denied claim. 90% on claims is a terrible percentage.

[–] [email protected] 7 points 2 days ago

This is people’s lives they’re fucking with

[–] [email protected] 18 points 3 days ago

I wouldn't be surprised if they also carefully selected the "medical" part. Drug prescription? Medical. Post-intervention recovery? Not "medical".

[–] Modern_medicine_isnt 39 points 3 days ago

Probably threatened to sue him if he didn't take it down.

[–] [email protected] 19 points 3 days ago* (last edited 3 days ago) (1 children)

Maybe we shouldn't be reporting on fucking twitter posts.

[–] [email protected] 17 points 3 days ago (1 children)

What reporting is there left? It’s not like news media can really be taken seriously anymore.

Most companies would rather believe they can use AI to solve everything, leading to less workers equaling higher profit margins. Which will be an even bigger belly flop.

[–] PunnyName 10 points 3 days ago

Reuters, AP, NPR, The Hill

But real news always starts local.

[–] Smashfire 10 points 3 days ago (1 children)