“Not Medically Necessary”: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care
When companies like Aetna or UnitedHealthcare want to rein in costs, they turn to EviCore, whose business model depends on turning down payments for care recommended by doctors for their patients.
A Doctor at Cigna Said Her Bosses Pressured Her to Review Patients’ Cases Too Quickly. Cigna Threatened to Fire Her.
Cigna tracks every minute that its staff doctors spend deciding whether to pay for health care. Dr. Debby Day said her bosses cared more about being fast than being right.
Doctors With Histories of Big Malpractice Settlements Work for Insurers, Deciding If They’ll Pay for Care
Doctors working for health insurers can rule on 10,000 or more requests for care a year. At least a dozen were hired by major insurance companies after being disciplined by state medical boards or making multiple or outsized malpractice payments.
Congressional Committee, Regulators Question Cigna System That Lets Its Doctors Deny Claims Without Reading Patient Files
The probes follow an investigation by ProPublica and The Capitol Forum that Cigna allows its doctors to reject hundreds of thousands of claims a month.
Health Insurance Claim Denied? See What Insurers Said Behind the Scenes
Learn how to request your health insurance claim file, which can include details about what your insurer is saying about you and your case.
How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them
Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.
Inside UnitedHealth’s Effort to Deny Coverage for a Patient’s Care
After a college student finally found a treatment that worked, the insurance giant decided it wouldn’t pay for the costly drugs. His fight to get coverage exposed the insurer’s hidden procedures for rejecting claims.
Do You Have Insights Into Dental and Health Insurance Denials? Help Us Report on the System.
Insurers deny tens of millions of claims every year. ProPublica is investigating why claims are denied, what the consequences are for patients and how the appeal process really works.
Senators Ask JPMorgan Chase to Explain Its Lawsuit Blitz Against Credit Card Customers
Citing ProPublica’s reporting that Chase had returned to the controversial practice of robo-signing in lawsuits nationwide, six Senate Democrats have asked Chase CEO Jamie Dimon to explain the bank’s practices.
A Return to Robo-Signing: JPMorgan Chase Has Unleashed a Lawsuit Blitz on Credit Card Customers
After a nearly decade-long pause, Chase has resumed suing indebted customers. The bank is back to its old ways, say consumer lawyers.
JPMorgan Chase Wrongly Charged 170,000 Customers Overdraft Fees. Federal Regulators Refused to Penalize It.
Documents and records show that bank examiners have avoided penalizing at least six banks that incorrectly charged overdraft and related fees to hundreds of thousands of customers.