I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals. Nearly everyone said the same thing: Great idea. But almost impossible to do.
GoodRx rolls out ‘real-time benefit check’ tool for providers
Prior authorization is a common cost-cutting tool used by health insurers that requires patients and doctors to secure approval before moving forward with many tests, procedures, and prescription medications.
Humana celebrates 10-year anniversary of National Senior Games program
Insurers’ denial rates — a critical measure of how reliably they pay for customers’ care — remain mostly secret to the public. Federal and state regulators have done little to change that.
A windfall in health insurance rebates? It’s not as crazy as it sounds
Millions of Americans in the past few years have run into this experience: filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied.
Congressional committee, regulators question Cigna system that lets its doctors deny claims without reading patient files
The probes follow an investigation by ProPublica and The Capitol Forum that Cigna allows its doctors to reject hundreds of thousands of claims a month.