Evi(L)Core is denying your insurance claims

I know several people who have been facing major end of life issues and been denied tests that their doctors say that they need to provide in order to survive. 

It is heartbreaking and the patients often no longer have the strength to fight. 

And it is not like humans are making these end of life decisions, apparently algorithms are running the show.

This company is helping insurance companies deny life saving coverage, EviCore.

...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.

The biggest player is a company called EviCore by Evernorth, which is hired by major American insurance companies and provides coverage to 100 million consumers — about 1 in 3 insured people. It is owned by the insurance giant Cigna.

A ProPublica and Capitol Forum investigation found that EviCore uses an algorithm backed by artificial intelligence, which some insiders call “the dial,” that it can adjust to lead to higher denials. Some contracts ensure the company makes more money the more it cuts health spending. And it issues medical guidelines that doctors have said delay and deny care for patients.

Hope there is a special room in hell for these bastards.