Health Insurance Company Caught Using Software To Screw Patients

Рет қаралды 141,080

Жыл бұрын

Health care giant Cigna has been using automated software to deny claims from thousands of customers. Ana Kasparian and Cenk Uygur discuss on The Young Turks. Watch TYT LIVE on weekdays 6-8 pm ET. kzfaq.infolive
Read more HERE: www.propublica.org/article/ci...
"When a stubborn pain in Nick van Terheyden’s bones would not subside, his doctor had a hunch what was wrong.
Without enough vitamin D in the blood, the body will pull that vital nutrient from the bones. Left untreated, a vitamin D deficiency can lead to osteoporosis.
A blood test in the fall of 2021 confirmed the doctor’s diagnosis, and van Terheyden expected his company’s insurance plan, managed by Cigna, to cover the cost of the bloodwork. Instead, Cigna sent van Terheyden a letter explaining that it would not pay for the $350 test because it was not “medically necessary.”
***
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@jim2376 Жыл бұрын

A Norwegian friend of mine said, "A country that doesn't provide health care to its citizens is not a serious country."

@catherinemitchell3721 Жыл бұрын

A Country that refuses to provide it's citizens even BASIC health care is a VERY sick Country.

@sixstanger00 Жыл бұрын

This country refuses to provide it's citizens basic anything....affordable housing, affordable groceries, reliable infrastructure, healthcare, education, living wage, etc. You name it and America is about 70 years behind the rest of the world.

@aaronderossett3998 Жыл бұрын

Even "3rd world" Cuba has better healthcare than us.

@carloscarion1748 Жыл бұрын

Yes, in a nut shell. You know I think I’m back on the history of this country and the people who first came here and their reason for coming here was to escape persecution and abused by others would not allow them right or who would make their life even more difficult than it seems to me that that same protocol has been threatened through our cultural existence in this country in order to get what we want. So essentially what I’m saying is we’re using the same things that drove us from one country to another in order to achieve what we want done, I’m in the process we have destroyed or decimated cultures, the beautiful things about various people and generally just made life more of a chore instead of a joy to experience

@edwardmikusek2307 Жыл бұрын

You are 💯 percent correct!

@stuffnuns Жыл бұрын

Crush the entire Healthcare Insurance business. We need a National Healthcare System, ala France, Spain, Belgium, Ireland, the UK, Germany, the Netherlands, Canada, Cuba, Japan, Italy, Austria, Portugal, et al.

@toastrecon Жыл бұрын

Also, medical bills are the top reason Americans get into poverty and never get out. The healthcare system is broken.

@monpayscanada Жыл бұрын

I worked for UHC for 15 years. They ABSOLUTELY used the “deny first and see who appeals” ESPECIALLY on seniors’ claims.

@Minabobina007 Жыл бұрын

Infuriating

@sclaw954 Жыл бұрын

as if we don’t already have enough to deal with- what happened to ethics, morals, in the medical field? good for you, insurance companies, you found a way to be financially successful. but you’ve clearly crossed a line here. people are needlessly suffering/dying so you can make an extra buck. keep digging that hole, bc at some point you’re going to drive this county to socialized medicine

@majorlazor5058 Жыл бұрын

Wow. My family is literally dealing with this right now. We have a family member who needs an injection every 6 months, but for some random unexplained reason was denied for the first time this past month. She has repealed twice now (her doctor was denied and now she is repealing herself). She is awaiting a response on the second appeal. It’s insanity

@thejane598 Жыл бұрын

Yes, I work in a doctors office and their “Clinical Required” is outrageous. The doctor for UHC dictates how many visits you can have.

@cookien8390 Жыл бұрын

@@sclaw954 There is a special place in hell for people that take advantage

@danielosko6366 Жыл бұрын

How does a Doctor process over 60,000 patients in a month? That's like seeing over 164 patients a day, every day, for 365 days in a year!!!!!

@stephenworthington-white8294 Жыл бұрын

As a Canadian I can't understand why Americans are not in the streets protesting against your insane "health care system".

@YaGotdamBoi Жыл бұрын

Unfortunately, it’s often because we’re too sick to risk losing our jobs (and our insurance coverage for doctors and medications), if we protest for too long that’s our bad, apparently. And we’re tired, so damn tired. It’s hard to fight when you’re barely able to meet your basic needs. That doesn’t mean we should stop and just sit with fingers crossed, but it does mean that all these systems are so detrimental to our mental/physical health that it largely keeps us down by the sheer force of the suffering it all causes us.

@markamiller1970 Жыл бұрын

Healt insurance is a scam. We need to get rid of all medical insurance companies.

@lenadahling Жыл бұрын

@@YaGotdamBoi When people have nothing to lose is when the guillotines come out.

@christophert6690 Жыл бұрын

because it doesn’t work!! you can say in the 60s it used to work but it’s no longer the case!

@lenadahling Жыл бұрын

@@christophert6690 False. Americans are whipped. The UK has been striking for months, and are making progress. You don't have the stomach for it. A general strike would cripple your country, and force change. But you're too whipped to do that.

@golfingrn4503 Жыл бұрын

As a nurse I can tell you that the reason it costs so much is we have to many middlemen!! Too many times have I seen doctors order meds for a sick patient but insurance said no! You have to use this drug! This is wrong! Take insurance outta the equation and prices for healthcare will fall!

@honeyblue2902 Жыл бұрын

Take *privatized, for profit insurance out of the equation, yeah

@ameeraxl Жыл бұрын

Insurance likes to play doctor.

@artvanderlay6974 Жыл бұрын

I know people who work in the insurance industry and they are basically trained to deny every claim no matter what. The goal is to force each claimant to jump through so many hoops and red tape that they eventually drop the claim. Insurance companies and banks are the biggest consumer predators out there. They will screw you the first chance they get!

@Playingwithproxies Жыл бұрын

yep its pretty insane that people would do that, but i guess Nazis were just people with jobs too. health insurance should approve every claim unless they have a doctor deny them.

@leschab Жыл бұрын

Look up Wendall Potter. He is still out there trying to educate consumers.

@mas5867 Жыл бұрын

These clowns have no idea what they are talking about here. The vast majority of conditions are far and away much more similar than dissimilar. If they are similar and decisions have already been rendered based on set criteria, then, "NEXT." AI ROCKS!. We need to replace emotional juries...NOW.

@peterboyd7149 Жыл бұрын

As someone from Scotland with an Amazing NHS. I would say to Americans image not having to worry about getting ill. If you lose your job you are still covered by our NHS. In Scotland prescriptions are free at the point of use and can be delivered to your door as part of our NHS. An Ambulance to hospital is also part of NHS. We have Nationwide screening programmes for Breast, Cervical, Prostrate and Bowel cancer. Caught early cancer survival rates increase. It is also cheaper for our NHS. We pay 6% on every wage for our NHS. Co-payments and out of pocket is not a thing here. We see healthcare and housing as housing as a right in Scotland. In the U.S. Owing a gun is a right therein lies the difference between Scotland and the U.S.

@robertkennedy8503 Жыл бұрын

Here in the US getting health insurance through your job is just another way for corporations to keep you enslaved, I know people that keep working past retirement age just to be able to afford the healthcare they need, good luck if you are jobless and sick.

@jim2376 Жыл бұрын

"In the U.S. [own]ing a gun is a right therein lies the difference between Scotland and the U.S." Sadly so on the American side. But there is one good thing about the otherwise worthless, stupid, totally unnecessary, violence enabling Second Amendment. The Second Amendment makes clear what NOT to do regarding gun policy. Our insanely violent experience with the Second Amendment is the perfect NEGATIVE example to the world. Scotland and other countries have wisely taken heed.

@carolynlanham3170 Жыл бұрын

In our dreams, USA.

@jim2376 Жыл бұрын

@@voirworks6002 "Main obstacle to universal healthcare is persuading anyone to pay tax." Definitely part of the problem.

@TheGholiday Жыл бұрын

The richest country in the world providing the worst healthcare in the world. Even third world countries have better healthcare systems.

@cjcarver6290 Жыл бұрын

We need healthcare, not health insurance.

@jackmedcalf6254 Жыл бұрын

I work in Canada. Vancouver B.C. patients spend 0$ a month on health care and they are covered for everything. They have a limit on how much they pay on prescription drugs a year and they are covered above that limit. All tests, hospitalizations are covered. There is something very wrong with the US system. Mostly it's greed.

@mariodipaolo8601 Жыл бұрын

I'm so grateful to be living in Canada where we have healthcare for all and where should a person come down with a catastrophic illness it won't send them to the poor house. A strong country is the product of its healthy citizens, and Canada has very good doctors.

@jenniferwelch9438 Жыл бұрын

@Mario Di Paolo sometimes we don't realize how blessed we are, eh!

@jackmedcalf6254 Жыл бұрын

@@jenniferwelch9438 Canada is the best country I've ever lived in. It's clean, it functions well, leadership is, for the most part, outstanding, and people are intelligent and kind. I'm lucky to have the opportunity to raise my family here.

@daguard411 Жыл бұрын

In 1883 Deutschland, (Germany) passed the Health Insurance Law written in most part by Otto Bismarck who is quoted as saying "A person's health should not be a commodity."

@litehold1144 Жыл бұрын

I have a friend who's husband was run over by the 16,000 pound tractor on their farm. It was a miracle he survived, no one else run over by the same size tractor has ever survived. He was covered by his health insurance, but then his COBRA ran out during his long recovery process. The cost of his prescriptions alone when his insurance ran out was $3000/month. Then they received a bill for $3,000 for a urine test. He couldn't work because of his injuries; his pelvis had been shattered and was held together with metal rods. He and his wife had to sell their farm and move to another country with a much better health care system to survive. The health care system in the U.S. is pure extortion.

@bobbii Жыл бұрын

That's why I fantasize about moving out of the US. However, I have nothing to sell and no resources, much like 99% of people in the same situation 😢

@litehold1144 Жыл бұрын

@@bobbii - I'm so sorry. That should not be, the US is so incredibly cruel and messed up.

@Stew-Ped Жыл бұрын

Insurance is a scam. You should receive a refund when it's unused for years.

@johncooper7663 Жыл бұрын

Was overnight in the hospital in Michigan for testing 5 years ago. $17,000 bill. Covered by my insurance. Exact same problem and testing in Florida 2 months ago. $68,000 bill. It's a game with no rules and it's out of control.

@Sharonmxg Жыл бұрын

health care should NEVER EVER have a for-profit business model

@Simmonsumers35 Жыл бұрын

The idea that the company that would pay out can choose whether or not they want to is insane to me.

@therealgaragegirls Жыл бұрын

I used to copywrite for a major U.S. insurance company. It's disgusting how insurance companies communicate and plan internally--to both screw over payers (the insured) and providers (doctors and hospitals). They are literally only concerned about massive profits. NO concerns whatsoever about payers' health outcomes or even their lives. It's revolting.

@kalijasin Жыл бұрын

You should be interviewed.

@thejane598 Жыл бұрын

I work in a doctors office, health insurance is ridiculous. We don’t take Cigna or Humana because of things like this. It’s disgusting.

@Minabobina007 Жыл бұрын

I had the insurance company refuse to cover imaging that I needed to properly diagnose me. My doctor appealed it, did a peer to peer, still denied it. Covid happened, lost my job. I ended up in Urgent care over my issue. They helped me apply for Medicaid. I got approved for Medicaid and was able to get all 5 surgeries that I needed. I’m so thankful I had medicaid and didnt end up with 1000s of dollars in medical bills.

@albertstephen2426 Жыл бұрын

Yet Americans consistently vote for people who deny them health-care and protect corrupt insurances and children from dragqueens , CRT, unwanted parenthood and at the same time give billions to an apartheid acist government and billions and billions more to Ukrainians.l

@Kari.F. Жыл бұрын

I live in Norway. I can't think of one choice that our universal health care system prevents me from getting. I may die from stage four cancer, but not because I'm denied the treatments and doctors I need to possibly survive, or at least live longer. (Cenk's story about his friend in Kansas is inhumane!) Loads of people here have private health insurance through their employers in addition to the regular health care. That's way the employees can get certain kinds of surgeries quicker (knees, carpal tunnel etc.) and thus get back to work sooner. That's for elective or non emergency health care. Nobody has to wait for emergency surgery. I had a heart attack a little over a year ago, and the total cost was 20 dollars out of pocket for the taxi ride from the hospital and back home. I paid 0 for the ambulance, hospital stay and surgery, and I had my surgery (a mesh stent) done by one of the best in the country. The food was surprisingly delicious, too. Hospital food used to be a sad affair of bland, overcooked food here. Not anymore, apparently. I could grab what I wanted from the self service cafeteria when I wanted a snack or a full meal. Their salmon was literally unforgettable. 😋

@calicocritterscrafts886 Жыл бұрын

When you made healthcare a for profit situation this is exactly what you get.

@chrisbankhead9669 Жыл бұрын

Insurance companies have a Utilization Management department that reviews medical procedures and records. I used to work for Cigna in medical utilization myself. This “new” way of denying claims isn’t new. They’ve been trying to do this since 2001. This is ridiculous. The state insurance boards need to investigate IMMEDIATELY!

@chrisbankhead9669 Жыл бұрын

Oh yeah, BCBS does it in Colorado and Nevada. I’m 💯% sure.

@RuthmarieHicks Жыл бұрын

This has been going on for years. No one tried to kill my father more than his insurer. I spent WEEKS of my time, neglecting my own career, trying to figure out how to overcome the lasted B.S. rejection. That was 12 years ago and it's only gotten worse over time. I finally had to record a call and demand that a physician explain why a certain STANDARD treatment was denied and what their protocol was for treating that specific disease. I asked it as a professional courtesy since I have a Ph.D. in microbiology and immunology. He finally got treatment. But that probably wouldn't work today.

@Franklin-fb9xp Жыл бұрын

I just joined Cigna. I'm 66 years old. They call us "CUSTOMERS " in the paperwork they send us. Not "Patients"....let me know where to join the class action law suits.

@bavery6957 Жыл бұрын

I worked in a life/health insurance company as my first job out of university. Worked there for a bit over 2 years - that was more than 30 years ago. No matter how much I've washed since then, I still can't get over the filthy feeling I have from that experience...

@trishayamada807 Жыл бұрын

I did collections. There is no such thing as “free” care. The ER stabilizes you then put you go. You will get billed. You will get sent to collections and in some states when we take you to court and you don’t show, you will go to jail.

@trishayamada807 Жыл бұрын

@@unebonnevie it was my job. It’s what hospital collections is about. It’s horrifying. That’s why I get irritated when people say you can get “free” care in hospital emergency rooms. No, it’s not free. They will treat you without payment upfront but you will be billed. You can hope they have a hardship program. Always ask! And for the patients that don’t pay, we all pay through higher fees. It’s just a truly inhumane system. I couldn’t keep doing that. It’s traumatizing.

@nogamesjustsports4104 Жыл бұрын

I live in Canada with my wife, who is from Canada I am from the United States. She never pays a doctor visit. She never pays for a prescription. I recently went to the ER last October bloodwork x-rays ambulance ride my cost without insurance was $900. The United States of America is not the greatest country in the world.

@GreaseWood-px4gk Жыл бұрын

Definitely a great scam!

@silkyh Жыл бұрын

I totally agree. I live in Europe and I can not believe how people are getting screwed in the US over healthcare!!! But they are so against universal healthcare. They call it socialism 😂😂😂They are being brainwashed by the government and the media. Well sooner or later they will realize that a good heath insurance is not socialism!!! It might take another 100 Years!!!

@jenniferwelch9438 Жыл бұрын

You got that right!

@joncoda365 Жыл бұрын

I am a clinic manager. Prior authorizations take up so much of our manpower to call and appeal claims. Sometimes my nurses (and occasionally I) spend hours of the day in the phone or faxing to appeal authorization denials. This is disheartening, but not surprising. Sometimes I’ve wondered how they were coming to these bizarre clinical decisions. It’s a damn robot doing it😢

@lilgpants Жыл бұрын

from someone who makes their living as a medical biller for a large, multi-state health care provider- THANK YOU for bringing any shred of awareness on this topic… most patients/people in the US in general don’t understand how our countries healthcare/health insurance system works at all, let alone understanding their OWN HEALTH CARE COVERAGE.. that’s 1000% the fault of our government and our health insurers. This should not be esoteric, clandestine information. It’s not a broken system, it’s a system built to only benefit the interest of the insurance companies. the figurative “rabbit hole” goes so much deeper than most of our country realizes, and while politicians are busy lying to benefit the corporations filling their pockets, our friends/families/neighbors are dying and their loved ones are left to argue with claims representatives reading from scripts in call centers on the other side of the planet over a medical bill for their deceased/dying loved one. *end rant*

@camcam3087 Жыл бұрын

This has been going on for decades. Having worked in healthcare, getting valid life saving surgery approved even when it’s under their guidelines to a T, they often would just deny first claim. When same exact paperwork sent again in appeal it would finally get approved. They would just do it almost for &&&&& and giggles and then when appeal sent, they’d finally throw their hands in the air. It’s like pulling teeth. Very sad for the ppl in this society

@cindyp5132 Жыл бұрын

I worked in the industry for many years as well. You're absolutely correct!! It's hard for me to even talk about because it's so unnerving. I 100% support MEDICARE for ALL!! People don't realize the corporate greed going on with their health. 🤍

@kathyd9324 Жыл бұрын

Do you really want your healthcare cost to include your portion of the 16.1 billion dollars of profit to insurance company stockholders, who do nothing for your care, they simply own stock? That 16.1 billion dollars would go a long way providing actual healthcare. Support Medicare for All

@rodneyharding1668 Жыл бұрын

UK 🇬🇧 Resident here And they call USA 🇺🇸 a Civilised Democracy GOD BLESS THE NHS!!!

@jaysea1553 Жыл бұрын

man we are lucky we don't have to deal with these crooks

@B_Bodziak Жыл бұрын

Cigna denied a very common surgery for me that would have removed pre-cancerous cells in my cervix.... Now, I have cervical, uterine and ovarian cancer. It's definitely not just Cigna that does this. It's United Healthcare, Blue Cross/Blue Shield, and others.

@drehardin Жыл бұрын

😢 Please fight. Don't let them win.

@lipglosslover83 Жыл бұрын

I pray you win your fight . They are even trying to deny other preventative services

@deea6240 Жыл бұрын

I’m so sorry.

@janbounds911 Жыл бұрын

Think I know abt this. There is a health clinic group in Spokane WA that has been using a computer program to diagnose patients for years. My husband and I recognized that they were Beta testing the program on said patients. It appeared they were planning for an automated health clinic. They missed my diagnosis for YEARS and I nearly died. We saw this IN ACTION! Nearly killed me for the profit. It's very real. Only country to allow healthcare for profit, to monetize it's citizens, for healthcare and as collateral for loans.

@EVtripper Жыл бұрын

When will we get Universal Healthcare like all the other democratic countries?

@veradouglass5630 Жыл бұрын

Thank you for informing us of this serious health insurance matter. This should be a crime.

@joncoda365 Жыл бұрын

Health insurance itself should be illegal.

@melissanoelle410 Жыл бұрын

I have pretty good insurance and I was charged $600 for a basic doctors visit and blood test. This whole system is infuriating!

@koru9780 Жыл бұрын

Why in the name of humanity would ANY doctor do this? Rise up people. Every doctor doing this should have their licence removed and the insurance companies dissolved.

@ritaobrien2779 Жыл бұрын

My husband needs a certain diabetic medication. The pharmacy will not fill the script because it is over $1,000.00 a month and our insurance will cover only a fraction. So the pharmacy refuses to take a huge loss. We pay over $15,000.00 a year for our coverage and can't get the medication to help my husband be healthier. Down right disgusting.

@pyrexmaniac Жыл бұрын

Thank the politicians who refuse to rein in the cost of specialty medications. I'm in the same situation but fortunately I live in New York State where I qualify for a State program that covers copays for most of my medications. My annual out-of-pocket cost without the extra coverage would be almost $23,000 EVERY YEAR. That's more than 80% of my monthly Social Security check.

@albionmerrick Жыл бұрын

I just spent years calling over 100 therapists to find one in my network that is taking new patients. I was just talking to a nurse at a birthing center who said they only take one insurance now because 80% of their bills went unpaid by insurance on the last year.

@jim2376 Жыл бұрын

Egads!

@gordonwallin2368 Жыл бұрын

My God; companies deciding who gets coverage that was paid for. Thank God-and I'm not religious, I'm a Canadian with "socialist" government health insurance. (PS, my kids cost $12 in the '80s each to birth, and the biggest wait was when there was a bus crash, I waited 2 hours. Free; that's real land of the free.) Cheers from the Pacific West Coast of Canada.

@j.c.ulater6892 Жыл бұрын

And when ppl ask what's even the point of health "insurance" and here u have it... The point is to deny as many people as possible to maximize PROFITS

@RebeccaTreeseed Жыл бұрын

They are paid to refuse payment. I had to change doctors every year for 15 years, through my company's constant changes in providers. Essentially NO insurance. Government coverage cannot be worse.

@Daedalus_Dragon Жыл бұрын

120,000 a month, if you did nothing but look at claims 8 hours a day 7 days a week that would be ~9 claims every minute. Insurance is one of the biggest scams we allow in this country. It’s a joke.

@bcreason Жыл бұрын

In Canada we have government run universal healthcare and almost most everything is covered. Your doctor can warn you of the few things that are not before hand so you can have the choice to go through with it or not. I've never heard of a claim being rejected. Healthcare is not tied to your job and there's no such thing as pre-existing conditions. One thing I can't stress enough is, it's cost efficient. It's run like a nonprofit, there's no multimillion dollar salaries for company officers (CEO, CFO, COO, etc.), no dividends to stock holders, no marketing with expensive billboards and TV ads, no sales commissions, it's just one entity not like the dozens in the US all requiring buildings and staff. Costs are also kept low by negotiating prices, with hospitals, drug companies and suppliers.

@SanePerson1 Жыл бұрын

In 'Murica this is just commie talk ...

@DianaLopez_ Жыл бұрын

The greed of these people is insane.

@simonmultiverse6349 Жыл бұрын

Freedom! This is AMERICAN FREEDOM!! You are free to receive our middle finger any time you like!

@DianaLopez_ Жыл бұрын

That's no new, all insurance companies have this type of nonsense denials. They are a nightmare to work with

@zacharyforeal Жыл бұрын

My best friend passed away because his claim for an insulin pump was denied over and over. He died in his sleep because his blood sugar dropped. A pump would have saved his life that night.

@jim2376 Жыл бұрын

Damn! Outrageous. His family might want to talk to a lawyer. At least in California, a claim can be pursued by the estate of deceased.

@carrieullrich5059 Жыл бұрын

😥

@butthurtz5025 Жыл бұрын

American health care for profit. It's like for-profit jails. If you're poor, it sucks.

@siriusnut36 Жыл бұрын

My Insurance said I didn't need an ACL when I was injured at work. So...I don't have one in my left knee. It buckles and bends weird plenty...hurts. But...people don't need them according to the insurance company.

@madusonkeeper Жыл бұрын

When you are paying someone to deny they are going to deny,deny,deny

@gypsyart6040 Жыл бұрын

I am completely blind in my right eye, permanently blind. I need a glasses/eye health exam and glasses 1x a year to function, be able to see from my left eye. Medicare says I get 1 exam a year covered. No glasses coverage. But 1 exam a year. They now do NOT cover the refraction portion of the exam. You CANT complete an exam WITHOUT the refraction portion! The docs therefore have to charge each patient $45 for the refraction. If you can't afford the $45 due to a limited income for being disabled or a limited income for Seniors you can no longer get the necessary exam. So its not just private insurance but Government insurance as well. These insurance companies are practicing medicine WITHOUT a license! That's a crime, a felony! But insurance companies do it every day!

@ebgewen Жыл бұрын

Your doctor should appeal denial to Medicare (or even before your tests are done for pre-approval) stating why your reflection is MEDICALLY NECESSARY and your tests may then be paid. If they just file the form with the usual codes, it will be denied. Must go the extra step and state MEDICALLY NECESSARY FOR AN EXCEPTION. Good luck!

@johndoe-ep7qk Жыл бұрын

we really need to get for-profit insurance companies out of our healthcare system, especially hospital/ER care...it's so over the top outrageous what they charge.

@inctru Жыл бұрын

Certain essential services/functions in society should not be run & controlled by greedy, predatory, corrupt corporatists. Health care is one of the them.

@karencurtis4604 Жыл бұрын

Insurance was never intended to be a “for profit” business. It was intended to break even including admin expenses. 😢

@MiracleFound Жыл бұрын

It is a for profit business and has been since the mid 1970's. It has gotten worse and worse over the decades.

@fredflintstone505 Жыл бұрын

I have Cigna and they suck. I pay $800 per month for it through my employer. To get anything else for the same coverage would cost me about $500 more per month. What worse about this is that you have already had whatever medical thing done before you find out you have been denied so your on the hook for the cost. I always ask what is it going to cost and nobody can answer the question. If I took my car somewhere to get it fixed and they couldn’t give me a estimate, I would immediately go some where else and never go back to that one. But with healthcare, that’s the norm.

@espoespo3557 Жыл бұрын

This is scary. I have Cigna as my health insurance. I had a 2 surgeries 4 weeks ago and then some more stuff was done. They paid all the claims which was about half a million dollars. I honestly never thought it was that expensive. I'm left with a 5 thousand dollar bill that I have to pay out of pocket, which in my opinion is reasonable compared to the rest of the bill. I don't know what I would have done if these claims sent to them by the hospital had been denied. Mercy!

@serendipityshopnyc Жыл бұрын

The insurance company that uses such software knows that many of these claims can be successfully appealed and the decision overturned: they're just counting on many people not noticing or being too lazy to appeal. The downside is that any patient who figures out this BS is likely to change insurance carriers in a hurry....

@kiLLinEmSoFTly Жыл бұрын

This is criminal. Absolutely unacceptable!

@vincentdinatale6962 Жыл бұрын

Soon USA citizens will go to a restaurant, will be required to pay prior to ordering and then be refused service on the ground that the waiter does not like them ! 😂

@caller4522 Жыл бұрын

Thank Richard Nixon for this. All Insurance use to be not for profit until Nixon and his Republicans changed the laws.

@garryferrington811 Жыл бұрын

I didn't know that.

@astheemeraldfalls Жыл бұрын

Every company is like this. They try to add a bunch of requirements on the paperwork, request a bunch of tests/chart notes/etc. within a certain amount of time, then electronic vs print signatures, prior authorizations, codes for coverage, etc to the point where it’s so complicated that they hope patients will not get the products or procedures needed. It’s really hard going back and forth with patients, insurance teams, doctors, and the office staff of the doctors between faxing docs and multiple phone calls. Many of the doctors do not know which company accepts what. 🤦🏽‍♀️

@dougthomson5544 Жыл бұрын

Insurance companies are NEVER there to help you, ever!

@sarahbourne4312 Жыл бұрын

What medical school did the Insurance company attended

@Kelly-- Жыл бұрын

wow. they could deny over 600 claims before this video would be done playing. they're totally uncaring plus greedy

@lynnebarrett9912 Жыл бұрын

They've been doing this for YEARS.

@writerconsidered Жыл бұрын

The other lie about that "freedom" is freedom of choice. The vast majority of people get their insurance through their employer. So the employer decides what insurance to give you not the consumer. So your choice is either except their insurance or not. So the insurance companies basically have a captive clientele. If you have a negative outcome from an insurance company you can't just dump them and find a better insurance company. The real customer isn't the patient its the employer and the employer wants the cheapest option available not the best insurance for the employee.

@markamiller1970 Жыл бұрын

We need to get rid of health insurance.

@ScaryPink Жыл бұрын

I really hope America will get universel Healthcare one day, cause that system sounds crazy. I can't even imagine life with out universel Healthcare.

@notalone4015 Жыл бұрын

The first thing America needs to do is outlaw lobbyists, overturn "citizens united" and put an end to gerrymandering. Maybe, just maybe, after that they'll provide Americans with universal health Care because they know we'll be able to vote them out of office.

@666MaRius9991 Жыл бұрын

@@notalone4015 Even the aliens know the jig is up 👽🖖

@rayclark7963 Жыл бұрын

I think we need to set a date, say 7/4/23, and the whole country just STOP paying ALL insurance premiums. Shut them DOWN...

@matthoskin3572 Жыл бұрын

America this is what you get for not holding anyone accountable. You continue to vote for people that only care about themselves and being paid by lobbyists. You are the ONLY country that has this awful model of healthcare. The richest country with the most expensive, yet least effective healthcare system.

@sheilarough236 Жыл бұрын

A long time ago, I worked in a psychiatric residential facility. One of our residents had a rare seizure/ brain disorder, requiring a certain very expensive type of seizure medication. She & her doctors had tried many other medications, some she ended being allergic to, and others did not control her seizures. This one medication worked. Yet every quarter, there would be a request from her insurance to try less expensive and effective drugs. The charge nurse, the administrator, resident’s mother & the doctor would go round and round with the insurance to pay for the medication. Sometimes the mother would have to pay out of pocket for the one medication that kept her daughter from having constant seizures

@jojomakes Жыл бұрын

And don't even get me started on dental insurance!!

@DairyAirGunners Жыл бұрын

In a profit driven health insurance system, it will always be more profitable to deny claims, rather than to approve them.

@davidhutchinson5233 Жыл бұрын

Nothing new there. Insurance companies have a policy of denying just about every initial major claim.

@robscorner1257 Жыл бұрын

Cigna did it to my wife six months ago, with no recourse or accountability.

@randalsoulfire Жыл бұрын

Just to make a comparison. I work at an insurance company in Europe and recently we've also adopted an automated system to respond to claims. The difference is that it's inverted. Most claims that usually don't require medical analysis are authorized by the system,, All others are subject to review by our doctors and, if any doubt arises, we ask the customer for additional info before either authorizing or denying the claim. It's not a perfect system but it's better than the one from Cigna in my opinion.

@tres5533 Жыл бұрын

Oh Blackstone! That explains it. They got one of their satanic trolls to come up this great idea.

@King_Dusty_Of_Pookytopia Жыл бұрын

Looks like we found the real "death panels"...

@dominicrossitto5890 Жыл бұрын

Just what I was going to say. You hit the nail right on the head.

@gglen2141 Жыл бұрын

This is old news. Ins companies have "auto-denied" for years. 30% walk away and this save the Ins. Co BILLIONS of dollars per year. Insurance in America is a scum business.

@bcvijasiu Жыл бұрын

This has to stop. I know politicians will not allow it, at least not at this point. One way to deal with it, just like dealing with the whole capitalistic system, is by shutting off the flow of capital. If there was only a way to convince everyone in the US to opt out of health insurance for at least 6 months and we would sink the health insurance industry. The doctors would have to treat the people still due to ethical responsibility.

@333kbool Жыл бұрын

The problem is that many medications, when combined, cost more than a person makes in a month. So in 6 months, those people would be dead or in worse debt than being in debt while still having medical coverage.

@jasonfuller1001 Жыл бұрын

For profit medical system is a horrible idea. The FIRST priority it profit, the second is patient. Could you imagine if emergency services were this way? Your house burning down? What insurance plan do you have? Oh, the HMO? Okay, we'll send 3 guys in a Nissan pickup but they need to use your hose.

@elizabethb3436 Жыл бұрын

Nothing public should be a business. Example prisons, insurance, ect...

@gkarak1996 Жыл бұрын

Add schools and hospitals that are placed that should be mostly public and publicly founded

@olveraolvera3226 Жыл бұрын

Wrong: Many USA prisons are a private business. Cost of students in public school per year: $14,000 Cost of housing prisoner per year: $45,000 Range is $18,000 in Mississippi to $135,000 in Wyoming. Republicans refuse to increase money for education and indeed try to control education downward. Low pay, low resources and poor facilities for education is the Republican agenda. However Republicans tout how tough on crime they are by pushing for more prison construction. Free food, free housing, free healthcare, free cable, free education, free gymnasium, free clothing, and a 24/7 guard in case some school children decide to go the prison and cause trouble. Have to protect our prison population from crazy students.

@zbaby82 Жыл бұрын

I read somewhere that heath care costs were cheaper before the insurance companies got involved.

@georgesheffield1580 Жыл бұрын

Not only cheaper but much better outcomes .

@micahnightwolf Жыл бұрын

I'm never going to pay for private healthcare, since they're never going to do what I would be paying them to do. If I experience a medical emergency and don't have employer-provided healthcare, I accept whatever will happen, including my death. It's depressing to say that, and it's depressing to be in this situation, but that's just the way it is in America right now.

@mick8888V Жыл бұрын

My SS Disability claim took 2+ yrs to be approved. The adjudicator asked if I thought I could at least work licking envelopes. I replied...well I do have a tongue, but thought we moved on from that with water rollers or wet sponges. I lost everything including my home awaiting SS's decision. Perhaps SS uses the same software...my lawyer told me that ALL applications are denied initially and appealing the decision is required. Cool.

@suecbrn Жыл бұрын

Your lawyer is wrong. I helped my Aunt with her claim. She got it first try. It really depends on who is filling it out and what information goes on there to make the case. This is best done by an RN, NP, PA or MD/DO.

@mick8888V Жыл бұрын

@@suecbrn Thx Susan. Might I ask how long it took and the state you reside? I was in NJ at the time.

@suecbrn Жыл бұрын

@@mick8888V MA and I think it was about 2 months or so.

@mick8888V Жыл бұрын

@@suecbrn WOW!!! Thanks Susan.

@bigmike6461 Жыл бұрын

Anyone actually surprised. What happens when your healthcare is focused on making money rather then Patient care.

@williamvergerwolf150 Жыл бұрын

Why I didn't bother to see a doctor when I technically had Cigna through work, worthless insurance

@jim2376 Жыл бұрын

Here's a contradiction/hypocrisy I've noticed with health insurance companies. If you ask for a premium discount because you are in excellent health for your age (and are capable of proving it on a treadmill, with blood, body fat, and blood pressure tests, etc.) the insurance company response will be, "We only insure groups, not individuals." Bullsh t. Apply for insurance with a pre-existing condition and the insurance company sure as hell will fix your premium on an individual basis. Only surcharges for bad health, no discounts for good health.

@appletile2887 Жыл бұрын

Insurance is legalized extortion....they sell you a promise....if you try to collect you are in a war with them. Socialized medicine is the only way to go. Arrest every GOP politican

@dem7615 Жыл бұрын

Private ins companies are taking over..Advantage plans the same situation . we are clueless ... Stockholders are in charge of your health.

@paulinskipukprogressive4903 Жыл бұрын

Utterly horrifying Conservatives want to do this to us in the UK too

@erich6860 Жыл бұрын

Conservatives are vile, apparently no matter what country they reside in.

@lindawarren2393 Жыл бұрын

last year 117,000 doctors left the health care system in America....this is the cruel reality of our system. Making money on pain and suffering is immoral.

@01man01truck Жыл бұрын

This is just another reason why wealth should be capped. Private and corporate.

@seviregis7441 Жыл бұрын

Last summer I rescued two baby deer who were trapped in a wrought iron fence and were dying there. Poor babies. But fortunately we got them out safely and the injured one was taken to wildlife rehab. However while I was saving them, I was eaten by a swarm of diseased mosquitoes. Hundreds of bites. These bites made me very sick and I couldn’t get any help. I went to doctor after doctor and no one would help me or even know what I had caught, which seemed like a combination of West Nile virus and mosquito borne parasites. I had to treat myself which finally worked. But they left me sick and incessantly scratching for 8 months. It was at that time that I saw what has happened to our health care industries, 100% bought out by hedge funds and other investors who now own and influence the insurance companies. Finding an independent doctor with room for a new patient is almost impossible. This is one of the most frightening quiet changing of the guards that I have seen lately. It is truly terrifying because anyone of us to get sick or injured unexpectedly and real health care no longer exists.

@charingram5231 Жыл бұрын

Many, if not most, of the doctors who review claims do not have practical expertise (including certifications) in specific specialties. Ex: a medical review whose expertise in gynecology may be reviewing for a cardiology claim. THIS IS WHY EVERYONE SHOULD FILE AN APPEAL IF A SERVICE OR MEDICINE IS DENIED BY YOUR INSURANCE and ASK WHAT ARE THE QUALIFICATIONS OF THE MEDICAL REVIEWER WHO DETERMINED DECISION.

@katiedid1851 Жыл бұрын

Our healthcare system seriously lacks CARE. All about the $$. We truly are prey.

@conrioakfield414 Жыл бұрын

All insurance companies are grifters, but the health insurance above all. It used to be, back in the day, companies would offer company paid medical benefits. The moment the g'ment, under lobby pressure, allowed HMO's to be created, health care affordability began a downward spiral.