I first caught up with this article on MedPage Today, “Doc Blows Whistle on Cigna.” I also read the ProPublic report. Both are reporting on denial of claims before and after treatment and the productivity of claims reviewers. Additionally, the report discusses the use of labor (nurses, etc.) outside of the US to evaluate claims and their errors. All of these attempts are examples of what is going on to cuts costs by reducing the time to decide on important procedures and functions which require a critical analysis.
The odd part of this is the reports do not appear to be just talking about MA plans.
Doc Blows Whistle on Cigna
Cigna increased its efforts to speed up claims denial by using new software and performance measures that pressured
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