Cigna, a US health insurance provider, is being sued for the second time this year for using automated intelligence to deny medical care claims so they don't have to pay for them.
“Cigna’s algorithmic review process trades patient care for profit, allowing the provider to eliminate the cost of necessary review by doctors and qualified professionals and instead rely on impersonal, illegal review by an almost completely automated algorithm.”
What is Cigna's defense?
They claim that because the review takes place after patients have received treatment, it does not result in any denials of care.
No one said you denied care, Cigna. You denied PAYMENT FOR CARE.
Hey Cigna, maybe you need to be reminded that the service you sell is PAYING FOR CARE.
Can anyone explain to me how come I was suppose to have a co-pay of $550 dollars for a CT scan, but then Cigna did not authorize the exam, so I was charged $400 which paid for the entire exam? Make it make sense.
From Courtwatch News: "Denied: Cigna was hit with a class action lawsuit for allegedly using an algorithm to determine whether treatments should be denied or accepted. The lawsuit alleges that the algorithm allowed “Cigna’s doctors [to] instantly reject claims on medical grounds without ever opening patient files.”" #Cigna#automation#healthcare#lawhttps://www.courtwatch.news/p/court-watch-37-cocaine-cruises-and
"Over a period of two months in 2022, Cigna doctors denied over 300K requests for payment using PXDX, spending an average of 1.2 seconds “reviewing” each request. One doctor alone denied 121,000 claims in that time period."
Update. "A new lawsuit alleges that #Cigna uses artificial intelligence (#AI) algorithms to inappropriately deny "hundreds or thousands" of claims at a time, bypassing legal requirements to complete individual claim reviews." https://www.medscape.com/viewarticle/995193