Obamacare

mickeyrat · January 12

https://www.threads.net/@senwarren/post/DEu6furRREP?xmt=AQGz5wEpEJ8brzrEWNcEBZRprI2W7SmDlVgNcrLULgZG8w

mickeyrat · January 14

https://www.threads.net/@propublica/post/DExtblbqFg5?xmt=AQGzMyBNNTOPvaTeY6LFCpHIowxcsn707yRL9BrjxKPHMg

mickeyrat · January 14

https://www.threads.net/@thetnholler/post/DEyQMVBMWfV?xmt=AQGzK839YM1LERLPIK9DA2vSHr7mrjnolNGekBL7W81g8g

mace1229 · January 14

mickeyrat said:

tools to learn why your claim was denied

https://www.threads.net/@propublica/post/DEBpQfoC7Fi?xmt=AQGz0VMsCkc1efh9pvRcnQBFBWpnH9_4ef-bSJJTPEXT4g

I might be using this at some point.
I've always thought insurance fraud should go both ways. Medical, housing, car, etc. If they deny my claims for non-valid reasons, why should they be treated differently than when I create a false claim? Hold them accountable and people will hate insurance less/

mickeyrat · January 16

https://www.threads.net/@perfectunion/post/DE2zXj4u0lw?xmt=AQGzwdzWXi5BWQajVRr3gUZjzYCllRSfhl5UprC-HnR51Q

mickeyrat · January 16

https://www.bbc.com/news/articles/cdxez3254lko

uhc ceo defends company in 1st earnings report since the murder

mickeyrat · January 18

mickeyrat · January 18

adjacent but here you go..

https://www.threads.net/@npr/post/DE8J8DDv0Op?xmt=AQGzTjrSau4ldMxYM7foyupD1DA-R_pgxlsjifyE06fpLw

mickeyrat · January 18

https://www.threads.net/@polizeros/post/DE8VHkTOT-g?xmt=AQGzT93D2Pgv7zCdVMTn1LDd1fdUYprObTxrwcg0XJwkug

mickeyrat · January 18

https://www.threads.net/@genx.twotoo/post/DE8RjCvSuIa?xmt=AQGzhlfWWC9VGDtMoI78Riv8NQg16m4cRFOhVLuDKyhAoQ

nicknyr15 · January 18

mickeyrat said:

https://www.threads.net/@genx.twotoo/post/DE8RjCvSuIa?xmt=AQGzhlfWWC9VGDtMoI78Riv8NQg16m4cRFOhVLuDKyhAoQ

It’s never “right” to murder someone.

josevolution · January 18

It’s also not right for these giant insurance companies to deny legit medical claims! Luigi is not the only one there’s more Luigi’s out here!

But I agree murder is not the answer not sure what the answer is?

nicknyr15 · January 18

josevolution said:

It’s also not right for these giant insurance companies to deny legit medical claims! Luigi is not the only one there’s more Luigi’s out here!
But I agree murder is not the answer not sure what the answer is?

Absolutely ! I agree. It’s disgusting. But there’s the other side of it which is the astronomical cost of medical care. Hospitals are not innocent in this asinine process either. But like I said, murdering CEOs isn’t “right” or the answer.

mickeyrat · January 18

nicknyr15 said:

mickeyrat said:

https://www.threads.net/@genx.twotoo/post/DE8RjCvSuIa?xmt=AQGzhlfWWC9VGDtMoI78Riv8NQg16m4cRFOhVLuDKyhAoQ

It’s never “right” to murder someone.

correct, but can you seperate the act from the thinking or conclusion on the topic itself? murder is murder no matter how you slice it. but was he wrong in what he wrote?

nicknyr15 · January 18

mickeyrat said:

nicknyr15 said:

mickeyrat said:

https://www.threads.net/@genx.twotoo/post/DE8RjCvSuIa?xmt=AQGzhlfWWC9VGDtMoI78Riv8NQg16m4cRFOhVLuDKyhAoQ

It’s never “right” to murder someone.

correct, but can you seperate the act from the thinking or conclusion on the topic itself? murder is murder no matter how you slice it. but was he wrong in what he wrote?

I have a hard time separating the two. Hes a murderer and the glorifying of him disgusts me.

josevolution · January 18

nicknyr15 said:

mickeyrat said:

nicknyr15 said:

mickeyrat said:

https://www.threads.net/@genx.twotoo/post/DE8RjCvSuIa?xmt=AQGzhlfWWC9VGDtMoI78Riv8NQg16m4cRFOhVLuDKyhAoQ

It’s never “right” to murder someone.

correct, but can you seperate the act from the thinking or conclusion on the topic itself? murder is murder no matter how you slice it. but was he wrong in what he wrote?

I have a hard time separating the two. Hes a murderer and the glorifying of him disgusts me.

I know it’s apples to oranges but but I feel the same way about the glorification of the incoming president people glorify him and we all know he’s an adulterer and a sexual predator! That disgusts me too

mickeyrat · January 19

https://www.threads.net/@rbreich/post/DFBWN5Co1EW?xmt=AQGzrROb-I9hg0Q6EVRvw-Pqi5FEJ4SPhFCYtiTpfR6GaA

mickeyrat · January 29

not exactly true in my case. we have an excellent hsa plan. 4k deductible 6k out of pocket max for in network family plan.

after company picks up 100% medical, offers co-pays on scripts that are tiered.

to wit. total knee replacement in Dec. Deductible met ladt April. 80k billed. 40k paid by company. NO QUESTIONS ASKED. have paid about 12-15 dollars for the pain meds the last 6 weeks. TOTAL.

but here ya go...

mickeyrat · January 30

https://www.propublica.org/article/department-labor-investigation-health-insurance-doctors-healthcare?utm_campaign=propublica-sprout&utm_content=1738238397&utm_medium=social&utm_source=facebook&fbclid=IwZXh0bgNhZW0CMTEAAR3Q8OLqpw3OKTayYlqvYJUlwuqQyU8QZJ1eB9LMqZEwF-RjZNSYA1OeEXQ_aem_5ZeQrYIma3Tug09H8Nazbg

Insurers Failed to Comply With Mental Health Coverage Law, Department of Labor Report Finds

The probe found widespread noncompliance and violations of federal law in how health plans and insurers cover mental health care, echoing the findings of a recent ProPublica investigation.

by Duaa Eldeib, Maya Miller, Annie Waldman and Max Blau Jan. 24, 2025, 6 a.m. EST

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Republish

Series: America’s Mental Barrier: How Insurers Interfere With Mental Health Care

More in this series

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

The U.S. Department of Labor found widespread noncompliance and violations of federal law in how health plans and insurers cover mental health care, findings that mirror a recent ProPublica investigation.

Health plans, and the companies that administer them, have excluded key behavioral treatments, such as therapies for substance use and autism, and offered inadequate networks of mental health providers, according to a 142-page report released Jan. 17 in conjunction with the Treasury and Health and Human Services departments.

The report, which the agencies are required to file regularly to Congress, also detailed the results of secret shopper surveys of more than 4,300 mental health providers listed in insurance directories and found an “alarming proportion” were “unresponsive or unreachable.” Such error-ridden plans, commonly known as ghost networks, make it harder for patients to get the treatment they need, ProPublica has previously found.

Since 2021, the Labor Department has addressed violations in health plans that serve more than 7 million people, according to the report. The agency has worked to remedy the problems by seeking changes to plan provisions, policies and procedures, as well as working to ensure wrongly denied claims were paid.

continues....

mickeyrat · January 31

https://www.propublica.org/article/evicore-health-insurance-denials-cigna-unitedhealthcare-aetna-prior-authorizations?utm_campaign=propublica-sprout&utm_content=1738322999&utm_medium=social&utm_source=facebook&fbclid=IwY2xjawIJuwJleHRuA2FlbQIxMQABHfAVRpytZN_Es1wK85xCOxSDUzO_xwmhzU7Iuy0SCC5S8ZS_z3xNiXEVEQ_aem_9MxBhs7BumUwAMhaNz2twg

Not Medically Necessary”: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care
by T. Christian Miller, ProPublica; Patrick Rucker, The Capitol Forum; and David Armstrong, ProPublica
Oct. 23, 2024, 1:30 p.m. EDT
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Co-published with The Capitol Forum
Series: Uncovered: How the Insurance Industry Denies Coverage to Patients
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ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.
Reporting Highlights

    Dialing for Dollars: America’s largest insurers hire EviCore to make decisions on whether to pay for care for more than 100 million people.
    “The Dial”: EviCore uses an algorithm that allows it to adjust the chances that company doctors will screen prior authorization requests, increasing the possibility of denials.
    Lucrative Deals: Some EviCore contracts are based on how deeply the company can reduce spending on medical procedures. It tells insurers that it can provide a 3-to-1 return on investment.

These highlights were written by the reporters and editors who worked on this story.

Every day, patients across America crack open envelopes with bad news. Yet another health insurer has decided not to pay for a treatment that their doctor has recommended. Sometimes it’s a no for an MRI for a high school wrestler with a strained back. Sometimes for a cancer procedure that will help a grandmother with a throat tumor. Sometimes for a heart scan for a truck driver feeling short of breath.

But the insurance companies don’t always make these decisions. Instead, they often outsource medical reviews to a largely hidden industry that makes money by turning down doctors’ requests for payments, known as prior authorizations. Call it the denials for dollars business.

The biggest player is a company called EviCore by Evernorth, which is hired by major American insurance companies and provides coverage to 100 million consumers — about 1 in 3 insured people. It is owned by the insurance giant Cigna.

A ProPublica and Capitol Forum investigation found that EviCore uses an algorithm backed by artificial intelligence, which some insiders call “the dial,” that it can adjust to lead to higher denials. Some contracts ensure the company makes more money the more it cuts health spending. And it issues medical guidelines that doctors have said delay and deny care for patients.

continues....

Obamacare

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Insurers Failed to Comply With Mental Health Coverage Law, Department of Labor Report Finds

The probe found widespread noncompliance and violations of federal law in how health plans and insurers cover mental health care, echoing the findings of a recent ProPublica investigation.

Series: America’s Mental Barrier: How Insurers Interfere With Mental Health Care

Categories