TerryRohrer
Senior Member
- Joined
- Aug 13, 2005
- Professional Status
- Certified General Appraiser
- State
- Montana
The following article is primarily about healthcare and how insurers are denying coverage of doctor recommended medical procedures. But the following little gem is exactly what many of us have been concerned about and warning about, and is certainly gaining ground in the CU/AVM unbiased world. Remember the old embezzlement schemes where the insider only siphoned off a penny or two a transaction and collected millions? The dial will be special!
"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."
"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."
‘Not medically necessary’: Inside the company helping America’s biggest health insurers deny coverage for care | CNN
Every day, patients across America crack open envelopes with bad news. Yet another health insurer has decided not to pay for a treatment that their doctor has recommended. Sometimes it’s a no for an MRI for a high school wrestler with a strained back. Sometimes for a cancer procedure that will...
amp.cnn.com