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Cigna health giant accused of improperly rejecting thousands of patient claims using an algorithm (www.witn.com)

submitted 1 year ago by btaf45@kbin.social to c/news@kbin.social

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The class-action lawsuit, filed Monday in federal court in Sacramento, says Cigna Corp. and Cigna Health and Life Insurance Co. rejected more than 300,000 payment claims in just two months last year.

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[–] falsem@kbin.social 2 points 1 year ago (1 children)

Is this not fraud if it wasn't actually reviewed by a doctor?

[–] btaf45@kbin.social 2 points 1 year ago

Although a doctor would be required to sign-off on the decision, their doctor simply reviews what the computer says So the doctor doesn't actually look at your individual case file like he should, he just rubberstamps in bulk all decisions spit out of the computer. So they will claim that they stay within the letter of the law by having a doctor "sign-off" on your decision, but in reality the doctor rubberstamps thousands of computer decisions all at once.