Posted on 12/15/2024 8:36:30 PM PST by SeekAndFind
Democrats on a Senate subcommittee are accusing UnitedHealthcare Group of denying claims to a growing number of patients as it tried to leverage artificial intelligence to automate the process.
In an October report, "How Medicare Advantage Insurers Have Denied Patients Access to Post-Acute Care," Democrats on the U.S. Senate Permanent Subcommittee on Investigations (PSI) released a report claiming UnitedHealthcare’s prior authorization denial rate for post-acute care jumped from 10.9% in 2020 to 22.7% in 2022.
Denial rates for skilled nursing centers, in particular, "experienced particularly dramatic growth." The number of denied claims in 2022 was nine times higher compared to 2019, according to the report.
During this same period of time, the company "implemented multiple initiatives to automate the process," according to the report.
The report also claimed United "processed far more home health service authorizations for Medicare Advantage members during this period, underscoring concerns about insurers rejecting placements in post-acute care facilities in favor of less costly alternatives," the report said.
FOX Business reached out to United for comment. In a statement issued in October, the company lambasted the report, saying it "mischaracterizes the Medicare Advantage program and our clinical practices, while ignoring CMS criteria demanding greater scrutiny around post-acute care."
The report surfaced as the largest health insurance company has come under fire for allegedly wrongfully denying claims in recent months. The murder of UnitedHealthcare CEO Brian Thompson in New York on Wednesday prompted more critics to air their frustrations with the company.
According to the PSI's report, a UnitedHealthcare committee approved using "Machine Assisted Prior Authorization" to speed up the process of reviewing medical requests in April 2021. The committee was told doctors or nurses still had to verify the evidence, but testing showed the technology could cut review time by 6-10 minutes, the report said.
(Excerpt) Read more at msn.com ...
This sort of thing should be done by human beings.
Only if the humans are qualified.
There is a problem here. The problem starts with Obamacare, and leaves it in hands of Big Tech.
This is about the sixth or seventh topic on this, part of the partisan media campaign to vilify the victim of the murder.
Since it is the Lyin’ Democrats raising the alarm I tend to doubt that any of it is true!
You are 100% correct. Once they worked with our scumbag politicians to make it that everyone HAD to get insurance, the rates skyrocketed.
And just what has the denial rate been for 2023 and most of thus year. Cms has rules for post acute care too ie skilled nursing care, or transitional care.
Of course.
p
They use a nurse to do visits and a Dr. signs off.
I appealed 7 times and won every appeal.
I finally accused the Dr. who was signing off for malpractice as denial of care is practicing medicine and he didn’t see the patient and was practicing outside his medical specialty.
On my side I had to neuroscience MD’s and stroke specialists requesting the treatment they were trying to deny.
I was doing this for a friend who had no family. The weeks immediately after the stroke are critical for recovery and they were denying care after a week.
Many nursing rehab homes and hospitals are suing them and will not take patients with their insurance.
I heard a rumor that the CEO who was shot was getting his health insurance from another company
AI is nothing more than a program. Written by humans. If it is corrupt, it is because of the coders that polluted the program.
Other than that, so bloody what? What, yah want to go back to slide rules for simple multiplication?
Murder is wrong and justice is coming for the murderer. Now where do the victims of UHC go to get their justice? You need to address that question.
And no lobbied for Obamacare? It wasn’t you or me.
Go back to a time when humans were less stupid? Is that a trick question?
How much do you know about medical coding?
Human beings aren’t needed.
SRA....... it built America
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