Health care giant Cigna has been using automated software to deny claims from thousands of customers. Ana Kasparian and Cenk Uygur discuss on The Young Turks. Watch TYT LIVE on weekdays 6-8 pm ET. http://youtube.com/theyoungturks/live
Read more HERE: https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
"When a stubborn pain in Nick van Terheyden's bones would not subside, his doctor had a hunch what was wrong.
Without enough vitamin D in the blood, the body will pull that vital nutrient from the bones. Left untreated, a vitamin D deficiency can lead to osteoporosis.
A blood test in the fall of 2021 confirmed the doctor's diagnosis, and van Terheyden expected his company's insurance plan, managed by Cigna, to cover the cost of the bloodwork. Instead, Cigna sent van Terheyden a letter explaining that it would not pay for the $350 test because it was not 'medically necessary.'
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230327__TA03Cigna
I have had a piece of cartilage broken under my knee for almost 2 yrs. My general practitioner refused to run a test. Sent me to a specialist which took me 3 month to get an appointment with. They refused to run the mri sent me to rehab. By this time i was almost 5 month with this broken cartilage bwfore going back to reg doc to run the test6 more weeks for the test now il at about 7 months. GP sends me back. I had to wait about 3 to 4 more weeks so we are at 8 months. I thought i would be seeing the surgeon.but no i saw the same as the 1st timethe was told it would be amother 3 month 4 that appointment. I broke down, otw to the appointment. When i told them i broke down i was given a new appointment with the surgeon 4 months laterwhich isnt till the end of oct. People would have medicaid dont get priority people with reg insurance do. If anyone can be wronged by the system it has wronged me over and again this is just the latest. Ssa lost my paperwork 2 times over 10 yrs to deny me my disability and put me on ssa instead of ssdi. Being a poor single disabled mom with 2 learning disabled children and one completely disabled. I have be a walking talking Murphy's law when it comes to the state letting you down
@jfarrell9915 Says:
r wing tells us that govt cant run things.......that's a r wing failure............
totally different to x40 other countries.
certainly usa free enterprise refuses to run a health sysyem with even a smidgen of morality....
@niko918 Says:
I have herniated discs and have sciatica pain, in 23 years and several health care plans I have never been denied care for my herniated discs. Cigna just denied care requested by my doctor for a my sciatica issues. CIGNA IS BOTTOM OF THE BARREL!!
@mariacastillo8060 Says:
Yes I want to know how they are getting away with this...isn't this theft
@mariacastillo8060 Says:
I am a victim and willing to fight for what I pay for and is rightfully mine. I am a brain tumor patient just got denied an MRI. What
@tjtreinen7381 Says:
don't blame the democrats.... republicans all have their fingers in this pie, by not regulating the industry..
@rebekahweber2413 Says:
It takes 1.2 seconds to load tge page and save the denial. They dont even know thd patient's name or diagnosis.
@brigspearman2171 Says:
I don’t believe in God
@fastmankim1 Says:
It's always been a rip-off
@MiraculousManifestation Says:
Claims have always been auto-adjudicated. A doctor will look at a very high level appeal...this isn't new.
@johnlightcap5041 Says:
Our president can’t even even put sentences together. Embarrassing!
@theinteriminformant6490 Says:
Without a doubt, this is messed up…. But I think there’s potentially another massive and equally news story within this one...
In 2010 they implemented outsourcing approval/denials process to an algorithm geared for profits over people… 2014, they add ‘Automatic Nervous Systems testing, a procedure for used in the diagnosis of diabetes and autoimmune diseases.
So why, after years of patient denials, are we talking about cigna’s unethical practices? The article doesn’t site numbers for patient denials before 2021, but the numbers they show cigna denied in 2021 are astronomical. In other words, this is a story now bc of the vast uptick in patient claims.
Very significant bc the covid vaccine rollout began in Dec of 2020, most ppl getting it in 2021.
Automatic nerve testing, the test mentioned in the article, would logically be a test prescribed to someone who took the jab and got injured- since one of the most common serious adverse reactions across all the covid vaccines is neurological issues
https://pubmed.ncbi.nlm.nih.gov/35326363/
Since the CDC just stopped reporting data and never kept track of health outcomes across all causes (not not just relating to covid) btw the vaxxed and unvaccinated, we have to look at outside indicators such as insurance companies to build our understanding.
Esp when throughput 2021 -2023 all cause morality rates that exclude covid 19 were consistently up 15% in countries with the highest vaccination rates.
https://youtu.be/jB0Tp1oM_t0
@lisapoo2081 Says:
So you need to call or have your doctors office call and ask to speak with someone in Utilization Management and you may need to ask to speak with the nurse or doctor in charge of claims and auths. As a patient you may not be able to call the Utilization Management and ask your doctors office to call.
@lisapoo2081 Says:
I hate to break it to you... Your insurance company does not want to pay out claims.
@lisapoo2081 Says:
100% true and they use it to approve authorizations and it can be very difficult for your doctors office to speak with someone to get this approved. I worked in the medical field getting authorizations approved for treatment.
@beatricesiaw8776 Says:
Paul Ramirez is probably the person denying the claims at united Healthcare
@cookien8390 Says:
Many insurance companies have policies to flat decline claims on the first submission
@buckmaster7185 Says:
Again, good reporting on ProPublica work. They need video exposure.
@IhaytFukkingsocialmedia Says:
LOVE YOU COMRADES!!! ROCK ON!!!!
@IhaytFukkingsocialmedia Says:
Time to start WAR on corporations!!! The capitalist class must come to ruin!!!!
@IhaytFukkingsocialmedia Says:
GO ANNA! YOU'RE MY HERO!!!!!
@IhaytFukkingsocialmedia Says:
so where are the laws, the legal involvement, suits, oversight boards, organizations, committees?
@adriftinaboat3452 Says:
OMG this shite is on its way to the U.K.
@raftguy1376 Says:
This is assuming the doctors office even accepts them. Most wont.
@reniasva Says:
Whenever I feel down I watch this channel and learn how bad Americans have it and I immediately feel better, realizing that I live in Western Europe.
@haruhisuzumiya6650 Says:
They automated the death panels
@haruhisuzumiya6650 Says:
Signa is a bunch of crooks
@kennethgarcia25 Says:
the kind of doctors who work for these insurance companies get fired if they approve too many patient care payments! the whole medical insurance business is about delay, delay, delay payments even when legitimate as this raises the probability that patients will eventually just have to deal with it and the doctors who provided the care will stop seeking their just reimbursement.
@shirleysear7168 Says:
Not at all surprised. Insurance companies are all about the $$$$$$$$$$$$$$ NOT patient care!
@lsimmons6517 Says:
Don't give up on appealing. Amoung my friends the appeals have worked sometimes. The appeal process is very dependent on the appeal skills of the health care professional going to bat for you. It's not right ! I wish you the best and hope your appeals work, or at least some of them do.
@charliebrenton4421 Says:
Woooooow. I’m shocked! Shocked, I say!
Capitalists doing capitalism.
@legenddaughterrd Says:
what they are doing stealing people information and using there aka alias identity theft time to shut these people down they are securities thieves
@dorenemcmahonhardy5484 Says:
The last thing a seriously ill patients have the energy to do is go over mountains of paperwork and appeals. I always wondered HOW medicare advantage could offer all those extra benefits that Medicare did not. Over billing Medicare is probably only one of their methods along with denials of treatment.
@jo902100 Says:
You know you can have a functioning private health industry whilst also having government providing base level healthcare as to not send the sick population into medical poverty many countries around the world have shown that it’s not that hard unless your from the United States
@garciagarcia4789 Says:
And why does black rocks name keep coming up on these bad business deals
@ilovecatvideos1851 Says:
The glass is either half empty or half full. With government run system the goal is to spend the least. In private insurance the goal is to put up hurdles and require prior authorization which requires time from your doctor’s office. They hope you will give up. It is just one more task like phone calls, prescription refills, correspondence, charting, and other administrative work that doctors office do not get paid for.
If insurance companies paid for every service, they would JACK UP PREMIUMS. I don’t condone automatic denials. It is lazy and dangerous.
This is just to say that “Medicare for all” AKA a public option will have guardrails as well or spending will be wildly out of control.
We are in a period of skepticism of expertise where people come in with a self mis-diagnosis and a demand for specific tests or treatments. This is largely a culturally issue and not across all demographics.
In the US if you have no health insurance get a primary care provider at reduced cost (based on your ability to pay with copays as low as $0) by searching “FQHC near me” for a federally subsidized health clinics that see uninsured, Medicaid, Medicare, and privately insured persons.
@callmebigpapa Says:
Sue the Dr personally who signed off on the denial.
@healthy2202 Says:
If your a boomer like me then you know that we are about to be exterminated. The insurance company denies medically necessary medication for us to live. There will me mass suicides from seniors in the next few years. It doesn't matter what the doctors say in necessary. I knew 3 seniors that took their own lives mostly because the meds are so expensive that they didn't want to ruin the surviving spouses financially. And the VA hospitals are ten times worse just in the last two years. I called and talked to triage RNs that never called me back to see my Primary care doctor ten times in two weeks. THEy told me to go to an ER, I did and was told to follow up with primary care dr. THey are cutting us off at the knees.
@YesThatPrettyGirL Says:
Here’s an idea. Let’s approve ALL claims that come in and then, we can countdown the days until the insurance company goes bankrupt, and NONE of us have coverage. How does that sound?
And yes, I’ve worked both sides of the spectrum, IN the trenches of ER/ICU for over 22 years.
YES! It SUCKS, but it is what it is. Unfortunately.
@namegoeshere3838 Says:
Sounds like the disability system. My doctor of course said I need immediately spinal surgery. Then, their doctors are supposed to say no and the appeals begin. Well their doctor agreed with my doctor, they fired him and denied me! 7 years & 9 months later I finally got in but too late for surgery so my life is oxycodone and a few others, heating pads, ice packs and pain
@kevincaldwell7431 Says:
Sounds exactly like the insurance company Great Benefit in the 1997 movie, ‘The Rainmaker ‘. Great Benefit to whom? The shareholders?
@nancyhodgeson7544 Says:
Time to learn another language and check my passport
@marketads1 Says:
NOT THE INTERCEPT!!!!
@faridajohnson3373 Says:
I thank you so much!
@kdrewm5061 Says:
Wow, it's almost like we live in a society that values money over human life. 😐
@chuckc7239 Says:
When a insurance claim is denied, you can file a complaint with the Better Business Bureau, and sometime get great results, the secret is, insurance companies do not want a complaint from the Better Business Bureau
@gabrielcornejo253 Says:
Hmm objectively automation is not the issue.
Think if there is a standard approach to something…say your ankle hurts, the cost effective first step is an X-ray, then MRI.
Don’t conflate automation with profit oriented system.
@Kinkle_Z Says:
Meanwhile, California won a ballot proposition in 2017 for a Medicare For All plan to cover every Californian!! We were so excited! We won! It sat on Jerry Brown's desk for a year while Insurance lobbyists were appealing it.... then ended up on Newsom's desk. In 2020 Newsom had yet to sign it into law!! Then he got handed a ONE MILLION DOLLAR check from a Health Insurance lobbyist and it STILL SITS ON HIS DESK UNSIGNED!! Some democracy! It's a pure fascist corporatocracy folks!
@Kinkle_Z Says:
"Healthcare DENIAL" insurance.
@Kinkle_Z Says:
In capitalism it's all about MAXIMIZING profits so Profits are IN COMMAND... NOT people. So "Private Healthcare" is an OXYMORON! For Profit Hospitals are an oxymoron.
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