Big companies rake in profits while doctors are saddled with yet another cost in a burdensome health care system.
The Big Story
Mon. Aug 14, 2023
A powerful lobbyist convinced a federal agency that doctors can be forced to pay fees on money that health insurers owe them. Big companies rake in profits while doctors are saddled with yet another cost in a burdensome health care system.
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How the Insurance Industry Denies Coverage to Patients
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.
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.
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.
Learn how to request your health insurance claim file, which can include details about what your insurer is saying about you and your case.
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