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‘Not Medically Necessary’: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care (scheerpost.com)

submitted 3 weeks ago by shreddy_scientist@lemmy.ml to c/usa@lemmy.ml

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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.

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[–] circuitfarmer@lemmy.sdf.org 8 points 3 weeks ago

An argument constantly made when Public Option healthcare was on the table under Obama: "you don't want the government getting between you and your doctor."

All of us have these giant corporations between us and our doctors. Corporations which can literally choose if we live or die. The current uproar is unsurprising, and it should not go away.