From Courtwatch News: "Denied: Cigna was hit with a class action lawsuit for allegedly using an algorithm to determine whether treatments should be denied or accepted. The lawsuit alleges that the algorithm allowed “Cigna’s doctors [to] instantly reject claims on medical grounds without ever opening patient files.”" #Cigna #automation #healthcare #law https://www.courtwatch.news/p/court-watch-37-cocaine-cruises-and

' "[Using PXDX] Cigna's doctors instantly reject claims on medical grounds without ever opening patient files, leaving thousands of patients effectively without coverage and with unexpected bills," the suit alleges ... For example, over a period of two months in 2022, Cigna doctors denied over 300,000 requests for payments using this method, spending an average of just 1.2 seconds 'reviewing' each request." '

#Cigna #HealthInsurance #algorithms #lawsuit #California

https://www.cbsnews.com/news/cigna-algorithm-patient-claims-lawsuit/

The entire business model is based on not paying claims. These companies don’t care about you. #Cigna

"Over a period of two months in 2022, Cigna doctors denied over 300K requests for payment using PXDX, spending an average of 1.2 seconds “reviewing” each request. One doctor alone denied 121,000 claims in that time period."

“Cigna has been knowingly & wrongfully denying their patients desperately needed healthcare while lining their own pockets,” Ryan Clarkson, one of the attorneys said.
https://www.statnews.com/2023/07/24/cigna-lawsuit-claim-denials/
#insurance #insuranceclaim #Cigna

I am very #depressed tonight. Fought #Cigna all day trying to get my #diabetes #medications. They continue to insist that I don’t need them. My blood sugar will be 300+ without it, but they don’t care. My doctor wants me in the med, but that is not important either. Our bank account is $500 overdrawn and the med without a manufacturer coupon is $1000 a month. Why should I even try to fight anymore? No one cares if I live or die why should I?

Congressional Committee, Regulators Question Cigna System That Lets Its Doctors Deny Claims Without Reading Patient Files
==

A key congressional committee asked #insurance
giant #Cigna to provide documents so lawmakers can examine the company’s practice of denying health care claims without ever opening a patient file.

The probe follows a ProPublica/Capitol Forum investigation that found Cigna allows its doctors to reject hundreds of thousands of claims a month.

https://www.propublica.org/article/cigna-health-insurance-denials-pxdx-congress-investigation?utm_medium=social&utm_source=mastodon&utm_campaign=mastodon-post

@garidin Found a list w/figures:
#Comcast $210,315
#Pfizer $150,930
#Walmart $140,000
#Anthem $130,000
#Lowes $125,775
#HomeDepot $125,000
#JuulLabs $125,000
#MatchGroup $125,000
#GeneralMotors $100,000
#AnheuserBusch $100,000
#Amazon $100,000
#Uber $100,000
#Cigna $80,350
#Tiktok $75,000
#1800Contacts $51,415
#CharterCommunications $50,645
#Chevron $50,350
#DowJones $50,000
#Oracle $50,000
#Fox $50,000
#Visa $50,000
#Nationwide $50,000
#JohnsonAndJohnson $50,350
(part 1/2)

Why is the U.S. #healthcare so messed up & so expensive&
.
Private #insurance takes your money and uses part of it to fight giving any of it back
☝️
That is literally the #business model for private insurance see: #cigna when people see evidence of they are like “wow water is wet, I never knew” shrug
Doctors & nurses have to fight to get patients the care they need, & everyone suffers
#covid #nurses #doctors

Health Insurance Company Caught Using Software To Screw Patients

https://youtu.be/sfx_QZU_0iM

Health care giant Cigna has been using automated software to deny claims from thousands of customers. Ana Kasparian and Cenk Uygur discuss on The Young Turks. Watch TYT LIVE on weekdays 6-8 pm ET.

#Cigna #Health #HealthInsurance #PreexistingConditions #TYT #TYTNetwork #TheYoungTurks

General Health News 3/31/23

ProPublica: How #Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them https://buff.ly/3LRPQQK

“Van Terheyden was right to be suspicious. His claim was just one of roughly 60,000 that Dr. Dopke denied in a single month last year, according to internal Cigna records.”

The Cigna review system allows its physicians to instantly reject claims without opening patient files"

7/n
https://drruth.substack.com/p/covid-news-and-more-33123

Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
#Cigna #HealthInsurance #Corruption #Healthcare

"Medical directors do not see any patient records or put their medical judgment to use, said former company employees familiar with the system. Instead, a computer does the work. A #Cigna algorithm flags mismatches between diagnoses and what the company considers acceptable tests and procedures for those ailments. Company doctors then sign off on the denials in batches, according to interviews with former employees . 'It takes all of 10 seconds to do 50 at a time.'"

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
"Cigna emphasized that its system does not prevent a patient from receiving care — it only decides when the insurer won’t pay."
#Cigna must know that people are less likely to seek care if they have been receiving unexpected bills. STOP THIS.
#healthcare cannot be a for-profit venture. National healthcare NOW. Plenty of people would still be doctors and nurses - and I think it would be much, much better.
#health #humanRights #ProPublica #uspoli

Doctors at a major US #insurance company deny tens of thousands of claims a month without even looking at #patients’ files.

“We literally click & submit,” a former #Cigna #doctor told ProPublica & The Capitol Forum. “It takes all of 10 seconds to do 50 at a time.”

Here's the inside story (THREAD)...

Surprising no one, ProPublica reveals that Cigna prioritizes profits over people by mass rejecting legitimate healthcare claims without review, counting on most people to just pay instead of appeal. I guarantee they aren't the only insurance provider doing shit like this. The U.S. healthcare system is fundamentally broken, and will remain that way as long as it is profit driven.

#cigna #healthcare #insurance #universalhealthcare

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims

' [Cigna] has built a system that allows its doctors to instantly reject a claim on medical grounds without opening the patient file, leaving people with unexpected bills, according to corporate documents and interviews with former Cigna officials. Over a period of two months last year, Cigna doctors denied over 300,000 requests for payments using this method, spending an average of 1.2 seconds on each case, the documents show. '

#Cigna #healthcare #RejectedClaims

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims

@ProPublica we had #CIGNA for like three years and it was a nightmare. They were absolutely horrible. We switched to #Kaiser this year and for all of the things that are unique to Kaiser and sometimes difficult to get used to, it’s been a dream compared to CIGNA.

Insured through #Cigna or #UnitedHealthcare?

ProPublica & Capitol Forum have investigated how these #health #insurance companies fight to reduce spending on patient care.

Join us Tuesday, 3/28 to learn our findings.

RSVP to this free online event here:

https://www.propublica.org/events/medically-necessary?utm_content=buffer17cf4&utm_medium=social&utm_source=mastodon&utm_campaign=mastodon-post

Cigna Health Insurer auto rejection of claims

One doctor denied 120,000 in two months despite being obligated to review medical records.

#HealthInsurance #Cigna

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims?s=09

How #Cigna saves millions by having its doctors reject claims without reading them. #insurance #healthcare #health #USA

https://www.rawstory.com/cigna-health-insurance/