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

propublica.org

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

#281

Post by whatthesmack »

alpaca128 wrote: post #160
stouset wrote: post #69

Earlier quoted context omitted.

Counterpoint. I have an Aetna PPO and experienced a stroke last year. $100,000+ hospital stay and insurance just… covered it. I paid $1,100 out of pocket. I had a $100,000+ surgery a few weeks ago to repair a heart issue that may have led to it. They just covered it. No fuss, no hassle. I paid $3,300, which was the remainder of my total annual out-of-pocket, and now I will pay $0 for healthcare for the rest of the ye…

> I paid $3,300, which was the remainder of my total annual out-of-pocket So with insurance you paid more than a European without insurance would, and you call that a counterpoint?

Sure, if GP is in the US and the European is paying 2-3x the income tax rate & earning half the salary.

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

#282

Post by explaininjs »

davidw wrote: post #272
djbusby wrote: post #241

Earlier quoted context omitted.

Lawyers, the best way to get reasonable healthcare in USA. What can be done?

Elect people, starting at the local level, who want to change the system? That change doesn't have to be 100% or perfect. The ACA ensured that a lot more people got covered, even if it was not perfect.

Like Bernie Sanders? Who was then placed in a debate in an “insurance town” where every audience question was some insurance leech complaint that his plan would destroy their jobs? Yeah dude. That’s the point, your job is bullshit and you shouldn’t be doing it.

The media also loved to bring on people who “adored their current insurance plan and would hate to lose it”. I’ve never met someone like that in real life, but the MSM would have you believing you were the only one in all of America who had any ill thoughts about their insurance company.

If voting could change anything it’d be illegal.

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

#283

Post by davidw »

dahfizz wrote: post #278
davidw wrote: post #272

Earlier quoted context omitted.

Elect people, starting at the local level, who want to change the system? That change doesn't have to be 100% or perfect. The ACA ensured that a lot more people got covered, even if it was not perfect.

The ACA just gave more power and money to these same scummy insurance companies.

So, no, definitely not perfect. Also, some people are alive today because of it, and many are healthier. I'll take that over a better reform that doesn't get passed, and keep working to elect the people necessary for better reforms in the future. This stuff just doesn't happen overnight, sadly.

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

#285

Post by Nihilartikel »

dcow wrote: post #126

What would be the problem with requiring all healthcare to be non-for-profit? You can still have it privatized, but you can’t ever be in a situation where you’re trying to maximize profits. Someone poke holes in the idea…

Sounds great, but to make it happen on a legal level, the public would have to mobilize enough money to out lobby the vast interests already enjoying complete regulatory capture. Also every advertisement block would have a 2 minute propaganda segment showing a grandmother suffering due to 'sclerotic non-profit ineptitude' that is inevitable when the god given American profit motive is stripped away.

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

#286

Post by whatthesmack »

Logans_Run wrote: post #173

Free Market, Self-Regulation, Share-Holder Value. My Friends, The Revolution is near. There comes a time when the common man can no longer stand idly by and watch as their brothers and sisters (and themselves) continue to be screwed over. There are many amongst you that fear speaking out in the vain hope that some day that they will get their share of 'the Good Life'. I regret to inform you that if it was going to ha…

There's no free market for healthcare in the US. What you mean is crony capitalism and corruption. If there was a free market for healthcare and health insurance in the US, it wouldn't be so expensive.

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

#287

Post by whatthesmack »

electrondood wrote: post #34

For anyone who is against government regulation... this is another perfect example of the kind of perverse financial incentives unregulated capitalism results in. Blanket denial without consideration lowers your costs as an insurance provider, because it acts like a filter on people who care enough to appeal repeatedly.

This is not unregulated capitalism. This is crony capitalism or corruption. It is government regulation that allows a monopoly of large corporations to remain the powerful health insurance companies they are, and ObamaCare gave them even more power.

If this was a free, unregulated market, healthcare in the US would be cheaper.

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

#288

Post by AnIdiotOnTheNet »

djbusby wrote: post #241
anonuser123456 wrote: post #215

Earlier quoted context omitted.

The sneaky thing to do is have your attorney send a letter to the insurance carrier's liability insurance provider, detailing everything you uncover and that they will be on the hook for the malpractice claim. That will get you an highly aggressive advocate with teeth.

Lawyers, the best way to get reasonable healthcare in USA. What can be done?

I mean, I don't want to say "start shooting them until they get the message that we won't put up with their bullshit", but I honestly can't think of a better plan given that people will find all sorts of excuses to keep voting for the kinds of assholes who prefer it this way.

I'd really like to hear one, cause the violence option isn't really very appealing.

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

#289

Post by loa_in_ »

ClumsyPilot wrote: post #276
Eric_WVGG wrote: post #264

Earlier quoted context omitted.

Here’s an example of something that happened to my sister that isn’t exactly the same, but is the same sort of philosophy in action. My sister was the manager of a coffee franchise named after a certain character from classic literature. Her location was doing extremely well, she was a competent type-A who commanded a great deal of respect in her entire district, and was generally assumed to on the fast-track for pro…

I understand that, but how is it legal to refuse to fullfil your insurance obligations without revealing the reasons? Like in US insurance is at will, okay, fine. But insurance is surely under a legal obligation to fullfill their end if the bargain?

I don't think you understand. They only have to make case for "their end" to not apply to the specific case, and it's okay. Same as firing someone for incompetence because you suspect them of theft. Realize, an employer has this option always. Why bother "playing the game".

> [...]you can't fire someone or deny coverage based on reasons that can be contested. It's not fraud if you fire them for some other reason. It's not fraud if you don't even know why you denied coverage.

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

#290

Post by vobox »

honkycat wrote: post #143

But hey: at least they owned the libs this month by passing a disgusting anti-trans bill. That is what is important right? Not stopping the massive corruption from every mega-corporation in every sector that is making our earth uninhabitable and our lives miserable. Lets hyper focus on people's sexuality.

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