Denying Care for Profit

Propublica reporting what many in Healthcare already knew. Insurance companies are medical claims and denying care to medically indicated procedures. The denial of procedures can lead to poor outcomes, but insurance companies dodge responsibility for their actions. It is incumbent upon the doctors and healthcare system to appeal the decisions. Also, it in the insurance companies interest to make the appeals process as labyrinthine as possible to deny more claims.

Medical providers are forced to hire more staff to appeal claims while insurance companies outsource the practice to the comically close EvilCorp company, EviCore. The expansion in staff results in administrative bloat. There need to be a mechanism for responsibility the people denying claims. Of course there should still be oversight to prevent doctors from doing medically unnecessary procedures.

Credit to Propuclica for the story and ChatGPT for the image.