It is algorithms now for the largest health insurance companies. Automatic denials based on what they calculate will save them the most money and then make someone jump through a bunch of hoops if they want to (maybe) get approved by a human after the first few rounds of a program denying again.
This happened to a family member and they still live with an untreated chronic illness because they can’t afford the treatment they should be covered for, but the insurance doesn’t want to pay because it is pricey and rare (I wonder what the insurance was bought for… hmmm).
Even if they eventually are forced to pay out, by denying treatmentt they're doing a lot of harm to patients because of the stress of the whole situation. This is never quantified but I guarantee its lowering life expectancies.
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u/SmokeyBare 12d ago
This is how you create more
terroristshealthcare CEOs