How UnitedHealth’s Playbook for Limiting #MentalHealth Coverage Puts Countless Americans’ Treatment at Risk
—

United used an #algorithm system to identify #patients who it determined were getting too much #therapy and then limited coverage. It was deemed illegal in three states, but similar practices persist due to a patchwork of #regulation.

#News #Healthcare #Health #Insurance #UnitedHealth #Medicaid #Government

propub.li/3Ogrfow

Inside UnitedHealth’s Playbook for Limiting Mental Health Coverage

United’s practices were deemed illegal in three states. But that hasn’t stopped the company from policing mental health care with arbitrary thresholds and cost-driven targets.

^ProPublica

Our "Uncovered" series has more on how the #insurance industry denies coverage to #patients.

One of the stories describes how Cigna #doctors reject patients' claims without opening their files. "We literally click and submit," one former company doctor said. 👇

#News #Healthcare #Health

propub.li/4dXhXs3

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.

^ProPublica

“Not Medically Necessary”: Inside the Company Helping America’s Biggest #Health Insurers Deny Coverage for Care
—

When companies like Aetna or UnitedHealthcare want to rein in costs, they turn to #EviCore, whose business model depends on turning down payments for #care recommended by #doctors for their #patients.

propublica.org/article/evicore…

#News #Insurance #Algorithm #AI #Healthcare

EviCore, the Company Helping U.S. Health Insurers Deny Coverage for Treatments

When companies like Aetna or UnitedHealthcare want to rein in costs, they turn to EviCore, whose business model depends on turning down payments for care recommended by doctors for their patients.

^ProPublica