Insurance has to be among the most corrupt and evil industries in the world.
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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.
The algorithm?
If claim then reject;
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'.
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
cigna balls lol
(fuck insurance companies)
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.