Insurers’ denial rates — a critical measure of how reliably they pay for customers’ care — remain mostly secret to the public.
ProPublica ProPublica <[link removed]> Donate <[link removed]>
The Big Story
Wed. Jun 28, 2023
<[link removed]>
How Often Do Health Insurers Say No to Patients? No One Knows. <[link removed]> Insurers’ denial rates — a critical measure of how reliably they pay for customers’ care — remain mostly secret to the public. Federal and state regulators have done little to change that. by Robin Fields
VIEW STORY <[link removed]>
Help Our Reporting
My name is Maya Miller <[link removed]>, and I’m an engagement reporter working on our ongoing investigation into the industry behind health insurance claim denials.
We recently published a guide <[link removed]> explaining how patients can request files that show why their claim was denied, including audio recordings of insurance company employees’ phone calls, internal notes and information on any cost-saving programs cases have been flagged for.
Some patients tell us they use the information in claim files to craft more effective appeals. Others learned how much their health plans estimated they would save by changing their treatment. A few have even obtained audio recordings of phone calls showing health plan staff introducing errors into their case records.
Taken together, these documents offer a window into the opaque system of health care denials.
The information in your claim files could help us identify systems that insurance plans are using to deny claims; we’d like to know more about what you’re able to learn. Here’s a form <[link removed]> where you can upload your files to help inform our reporting.
If you submit files, ProPublica reporters will be the only ones reading them. We appreciate you sharing your information and we take your privacy seriously.
Health Insurance Claim Denied? See What Insurers Said Behind the Scenes <[link removed]> Learn how to request your health insurance claim file, which can include details about what your insurer is saying about you and your case. by Maya Miller, with additional reporting by Patrick Rucker and David Armstrong <[link removed]>
Do You Have Insights Into Health Insurance Denials? Help Us Report on the System. <[link removed]> Insurers deny tens of millions of claims every year. ProPublica is investigating why claims are denied, what the consequences are for patients and how the appeal process really works. by David Armstrong, Patrick Rucker and Maya Miller <[link removed]>
More From This Investigation
How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them <[link removed]> 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. by Patrick Rucker, Maya Miller and David Armstrong <[link removed]>
UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings. <[link removed]> After a college student finally found a treatment that worked, the insurance giant decided it wouldn’t pay for the costly drugs. His fight to get coverage exposed the insurer’s hidden procedures for rejecting claims. by David Armstrong, Patrick Rucker and Maya Miller <[link removed]>
More From Our Newsroom
The Group That Governs U.S. Transplant Policies Voted to Require Testing of At-Risk Organ Donors for Chagas Disease <[link removed]> Bob Naedele died in 2018 after receiving a heart infected with the parasite that causes Chagas disease. The change in U.S. screening policy could prevent such deaths in the future. by Caroline Chen <[link removed]>
Baker College Faces Federal Investigation Over “Recruitment and Marketing Practices” <[link removed]> ProPublica and the Detroit Free Press found that Baker College spent more on marketing than it did on financial aid. Now, the school faces an inquiry by the U.S. Department of Education. by Anna Clark <[link removed]>
Supreme Court Keeps Navajo Nation Waiting for Water <[link removed]> Decades of negotiations between the tribe and Arizona over water rights have proven fruitless. The court case was the Navajo Nation’s bid to accelerate the process and secure water for its reservation. by Anna V. Smith, High Country News, and Umar Farooq and Mark Olalde, ProPublica <[link removed]>
Inside the Secretive World of Penile Enlargement <[link removed]> How a doctor’s two-decade quest to grow the penis is leaving some men desperate and disfigured. by Ava Kofman; Photography by Philip Cheung, special to ProPublica <[link removed]>
Behind the Scenes of Justice Alito’s Unprecedented Wall Street Journal Pre-buttal <[link removed]> The Journal editorial page accused ProPublica of misleading readers in a story that hadn’t yet been published. by Jesse Eisinger and Stephen Engelberg <[link removed]>
Organ Transplant Patients Can Die When Donors Aren’t Screened for This Parasitic Disease <[link removed]> Bob Naedele died after receiving a heart from a donor with Chagas disease. His death could have been prevented if the donor had been tested. The group that governs U.S. transplant policies is considering mandatory screening of at-risk donors. by Caroline Chen <[link removed]>
Find us on Facebook <[link removed]> Follow us on Twitter <[link removed]> Follow us on Instagram <[link removed]> Watch us on Youtube <[link removed]> Donate <[link removed]>
Get the ProPublica mobile app:
Download on the App Store <[link removed]> Get it on Google Play <[link removed]>
Was this email forwarded to you from a friend? Subscribe. <[link removed]> Want less email? Click here if you only want to receive one ProPublica newsletter each week. This email was sent to
[email protected]. Update your email preferences or unsubscribe <[link removed]> to stop receiving this newsletter. Email not displaying correctly? View it in your browser. <[link removed]> ProPublica • 155 Ave of the Americas, 13th Floor • New York, NY 10013 <a href="[link removed]><img src="[link removed]" alt="" border="0" /></a>
