This article first appeared at ProPublica and The Capitol Forum. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
The sheer greed of Cigna and other large insurers is not that hard to understand. What is hard to understand is how any doctor could be following their oath as a medical practitioner to basically deem so many procedures and tests, etc, as not medically necessaryâŚwithout ever having actually reviewed the claims in any detail.
I am about to not have a Cigna prescription drug plan. I have yet to get a prescription drug refill that wasnât cheaper using GoodRx than my Cigna plan.
Recently Aetna partly denied payment for my dental procedure that they had pre-approved. I grumbled and wrote a check. I think most people donât have the ability to win a fight against an insurance company. The numbers they put in their statements donât even make any sense.
I knew an RN who worked for an insurance company, denying legitimate claims. She quit after a year, unable to live with her conscience. Good to know now that a conscienceless algorythym is available to do her job. /s
Never give up on a claim. The squeaky wheel gets the grease.
The mother of my kids worked on these f*ckers for 6 months to get our kid surgery she needed, and she finally wore them down. Now the kid is in great shape, a month of healing later.
FTFY. (Note: Thatâs not saying doctors shouldnât get paid. Though of course, nobody should get paid, we should get past the monetary economy entirely into a glorious socialist workerâs paradise, but thatâs not gonna happen for at least half a dozen tech jumps yet.)
totally O/T FYI Trump Deletes Post That âThreatensâ DA Alvin Bragg (mediaite.com)
The Drudge Report, Matt Drudgeâs right-leaning news aggregator ran a headline on Friday declaring former President Donald Trump threatened Manhattan DA Alvin Bragg in a Thursday Truth Social post, which Trump deleted on Friday afternoon.
On Thursday, Trump shared a link with a split-screen image of him holding a bat on one side with an image of Braggâs head on the right.
Drudgeâs headline on the post read, âPSYCHO DON!â
âTHREATENS MANHATTAN DISTRICT ATTORNEY,â read the second line of the headline.
I have an expensive John Hancock Long-term Care Plan. Its very expensiveâ$2,300 per yearâfor someone with limited income like me. Iâve been paying for twenty years already. I too often think that I will die before accessing one penny or when Iâm in need, they will find an excuse to deny.
Also people are living longer, so every third year JH appeals to the state and always gets substantial raises to the rates. Theyâve offered to buy us out for what weâve put into it, with not one penny for inflation or interest given that theyâve had use of my money for all those years already. Now I understand why John Hancock can have a huge fancy building and can afford to put its name on so many high-end sporting events and facilities. I hate them.
The job of insurance companies is to make money and the easiest way for them to do it is too take your money and not provide necessary medical care. How those doctors running computer programs to deny coverage can look themselves in the mirror and not see a crook looking back at them is more than I can understand.
Iâd guess itâs not hard to incentivize that behavior. Since itâs trivial to deny, all thatâs needed is that it be more time consuming to approve and also to base performance on number of claims processed per unit time. Add to that dismissals of anyone who takes too long to process claims and you select for the behavior you want as well as incentivizing it