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Cigna saves millions by having its doctors reject claims without reading them

propublica.org

221–230 of 434 posts

Re: Cigna saves millions by having its doctors reject claims without reading them

#221
post #7

Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Any system that requires balancing human suffering against profitability is inevitably going to optimize for profitability. The fact that this is even a thing is mind boggling.

I knew I was going to see this comment.

As if Medicare didn't reject millions of claims too.

A number of physicians just don't accept Medicare because it's subpar.

Re: Cigna saves millions by having its doctors reject claims without reading them

#222

Earlier quoted context omitted.

Where is the wait only 30 minutes? Every time I've been to the emergency room the wait has been 6+ hours. I think the only way it would be that fast at the hospitals I've been to is if you'd die waiting longer, otherwise it's a long wait.

I am also fully insured and I have never once heard of emergency rooms with an average wait time of 30 minutes in the United States.

ProPublica has a tool that will provide the average wait time for hospitals in your area.

https://projects.propublica.org/emergency/

Where I live, all in driving distance have an average wait time more than 2.5 hours.

Re: Cigna saves millions by having its doctors reject claims without reading them

#223
post #122

Earlier quoted context omitted.

Because in US MRI is $1000 to $8000. It is a joke.

$550 for an MRI. https://tellicaimaging.com/

600 miles away. But yeah I can probably find one nearby for a couple grand. Still, that's insane.

Re: Cigna saves millions by having its doctors reject claims without reading them

#224
post #7

Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Any system that requires balancing human suffering against profitability is inevitably going to optimize for profitability. The fact that this is even a thing is mind boggling.

I see you've never had to do a major procedure in a "public" system.

Heh.

Re: Cigna saves millions by having its doctors reject claims without reading them

#225
post #79

Earlier quoted context omitted.

I have literally spent years trying to get an MRI for my knee after an accident. Both Kaiser and Anthem won't cover it.

I know it's still not cheap, but I needed an MRI a few years ago and it was $350. Talk to your doctor and let them know you want to pay cash. Mine suggested a place. Don't get one in the hospital if you can help it. They charge 1-2k because they have a full set of people who can't go anywhere else.

idk where you are but the hospital here wants 10k to do it and the private clinics are around $2k last I checked.

Re: Cigna saves millions by having its doctors reject claims without reading them

#226

The USA medical insurance system is missing a "stick" for such bogus rejections. Unduly denying a claim should result in a fine big enough to be felt in the company balance sheet, that is the only way to change companies' behaviours. , missing some kind of harsh

What if we just don't have a stick. The government or a company they hire is the party that reviews claims. The insurance contacts must have standardized terms and conditions. This probably wouldn't even really hurt the insurance companies. They would not need to compete with each other by denying claims on the backend to provide lower prices on the frontend. The current system is a race to the bottom.

The terms and conditions (usual and customary) are already there. People just don’t know what they are.

Re: Cigna saves millions by having its doctors reject claims without reading them

#227

Earlier quoted context omitted.

That won't help you there. Germany's public healthcare system denies plenty of things too, and will only pay for treatment when you sue (or know someone who works there). Germany's private healthcare system on the other hand is usually better (I'm sure there are exceptions and some insurance company that sucks).

You can have good public healthcare without the need of the notion of 'claims'. The Scandinavian healthcare system is a good example ( https://en.wikipedia.org/wiki/Healthcare_in_Denmark ).

The Norwegian public healthcare is great. The default recommendation to most health issue is to do more sport. Being very physically active usually helps, so it’s not a bad recommendation.

You may experience more pain compared to some other healthcare systems. Like France from my experience and probably USA from what I read.

I had some unforgettable experiences in Norway, such as a colonoscopy without sedation or anaesthesia in case I can tolerate the pain. I didn’t after a while.

Or some little operation that according to the English Wikipedia is done under general anaesthesia in USA. The doctor in my local small emergency room simply told me that the needle for a local anesthesia would be as painful as the operation so it’s unnecessary. She then asked a large nurse to hold me and I was given instructions about how to breathe. I think the doctor may have lied about the pain.

But I pay between $20 and $40 per visit and I don’t have to pay if it accumulates more than $300 per year. It’s also not connected to my work, I can be fired and still have the same healthcare benefits, forever.

Re: Cigna saves millions by having its doctors reject claims without reading them

#228
post #129
post #119

Earlier quoted context omitted.

Yeah, that's an idea. It's like 10k here. The trip to the EU, a vacation, and the MRI itself would be cheaper... I was actually planning on getting it done on my next trip to China, which is about the same cost wise, and the doctors are good as they see so many people lol

I get a screening in India when I visit some family there. Full blood work, you call in the morning, they come by the house and draw it, results in the next morning. It's faster and cheaper to do that, including the flights, than to try and get this done through my doctor in the US. So, yeah, go for it.

Not sure what you mean here. Services like Personalabs or just scheduling straight through Quest Diagnostics cost a couple hundred bucks for blood & urine tests on most things, there's probably a facility near you, and you get your results in a few days. I do it every few years with zero issues.

Re: Cigna saves millions by having its doctors reject claims without reading them

#229
post #190
post #101

Earlier quoted context omitted.

> Privatized health care as a person's sole option for care is an absolute dystopian nightmare. Dont exaggerate. I've lived in 3 European countries and Australia. My American healthcare is easily better than those. Sure I'm lucky to have a good job that pays for it, but you can't say its terrible without looking at how those public systems are really struggling right now.

We need to realize that publicized healthcare is the only option. Then we can focus on how to make it more efficient.

Unions on the left and most of the right are deadset against this.

It’s astonishing how much market inefficiency we’re willing to tolerate.

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