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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

#401

Post by pantulis »

LocalH wrote: post #144
pantulis wrote: post #115

Earlier quoted context omitted.

IMHO in privatized healthcare you are not the patient, you are the customer. As such, you should be having a better "customer journey" than in public healthcare: more immediate test/diagnostics, better experience in the hospital (like a room for yourself). And that's it. As a counterpart, it's not clear you are receiving the best medical attention. And of course you (through your employer) are paying for something th…

"Being the customer" doesn't matter one bit to most modern megacorps, because people are fungible to them. We constantly hear about big money screwing over little money. Small-time capitalism is quite good. Make a few millions, sure. I have no problem with that. But when the amounts concerned are in the billions? There needs to be massive oversight and regulation, regardless of the relevant field.

> There needs to be massive oversight and regulation, regardless of the relevant field.

Totally agree with that.

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

#402

Post by wolverine876 »

explaininjs wrote: post #282
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.

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, bu…

> If voting could change anything it’d be illegal.

Yet things do change, dramatically.

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

#403

Post by wolverine876 »

AnIdiotOnTheNet wrote: post #288
djbusby wrote: post #241

Earlier quoted context omitted.

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.

Who are you to impose your opinion on the rest of us? Who are you to shoot me or my neighbor?

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

#404

Post by wolverine876 »

bee_rider wrote: post #329
dahfizz wrote: post #278

Earlier quoted context omitted.

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

Yeah, we should have done some single payer system, medicare for all or whatever, but unfortunately we don’t have a very strong left wing in the US.

Blaming someone else is pathetic. It's not a system, it's you.

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

#405

Post by bee_rider »

wolverine876 wrote: post #404
bee_rider wrote: post #329

Earlier quoted context omitted.

Yeah, we should have done some single payer system, medicare for all or whatever, but unfortunately we don’t have a very strong left wing in the US.

Blaming someone else is pathetic. It's not a system, it's you.

I’m a U.S. voter, so yes I’m part of this collective failure to vote well/convince my countrymen to vote well. I’m not sure why you think I’m blaming somebody else?

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

#406

Post by hakfoo »

anotheraccount9 wrote: post #307
djbusby wrote: post #241

Earlier quoted context omitted.

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

Seriously consider a universal healthcare. Accept that it will be imperfect, but more balanced and will offer a chance to everyone. Another way to look at it: everyone pays for a healthcare insurance --> everyone gets covered.

Universal healthcare falls victim to the "I'm an above average driver" brainworm.

"I'm a healthy 22-year old male with no family history to worry about, go ahead and ravage the program to save me a nickel on taxes."

or, from the other side,

"I might need an ingrown toenail treated and how dare that go into a triage list and I have to come back in six months because there are more seriously ill people-- don't they know I'm rich and important?"

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

#407

Post by itsTyrion »

colordrops wrote: post #169
loeg wrote: post #29

> His claim was just one of roughly 60,000 that Dopke denied in a single month last year 60,000 / 20 workdays in a month / 8 hours in a workday => this guy rejected about 375 claims per hour, on average. Over six claims a minute. He spent less than 10 seconds on each claim, for a full month of work time.

This rate is pretty ridiculous. I wouldn't be surprised if there is automated software or a farm of non-medical staff working behind the name of the doctor, similar to how shady contractors will "rent" the license of a legitimate but retired contractor.

... it literally says in the article they have a program that goes over claims, says deny if it "thinks" it's "not needed" and humans confirm it in batches of 50.

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

#408

Post by explaininjs »

wolverine876 wrote: post #402
explaininjs wrote: post #282

Earlier quoted context omitted.

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, bu…

> If voting could change anything it’d be illegal. Yet things do change, dramatically.

And I do wonder what the root of that is.

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

#409

Post by wolverine876 »

bee_rider wrote: post #405
wolverine876 wrote: post #404

Earlier quoted context omitted.

Blaming someone else is pathetic. It's not a system, it's you.

I’m a U.S. voter, so yes I’m part of this collective failure to vote well/convince my countrymen to vote well. I’m not sure why you think I’m blaming somebody else?

You talk about a 'system'. The system is in the mirrors, yours and mine. We are it. American tradition is that one person makes a difference, which seems pushed aside now by the fetishization of despair and doom.

Also, it's about far more than voting. Voting is done every once in awhile. Citizenship is every day. Powers-that-be are watching and investing enormous energy in manipulating public opinion - for a reason. It's powerful. Today is the day to act.

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

#410

Post by explaininjs »

laurex wrote: post #399
explaininjs wrote: post #393

Earlier quoted context omitted.

The only path to substantial change is and has always been violent revolution. I welcome anyone to try that.

There’s nonviolent revolution, too. But it’s still likely to yield violence in response because these systems are inherently violent and ultimately enforced with violence.

What would you consider the most substantial change to come about via nonviolent revolution?
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