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They already can reject your appeal based on BS like you didn't fax a form correctly (or more likely, you did but they claim they didn't get it), or they requir
by mrgoldenbrown 2y ago
They already can reject your appeal based on BS like you didn't fax a form correctly (or more likely, you did but they claim they didn't get it), or they require a peer consult with your doctor and chose a time he wasn't available (on purpose).
And don't forget they already use tech to speed up denials - Cigna had one doctor "review" and sign off on 60,000 a month via automation. That's under a minute a case, assuming he worked 24/7. It takes longer than that just to fax in your form. So you submit an appeal via AI, they spend 20 seconds rejecting it, with their tech stack from a few years ago. If they invest in AI it's only getting worse for individuals unless there are new regulations that put the burden of proof on the corps instead of on patients and doctors.