Targeted Killing UnitedHealthcare CEO Brian Thompson became a turning point in December Public frustration with the health insurance industry. People are starting to share stories online about how insurance companies reject their reports and cheer up.
Assistant Professor Miranda Yaver said: “After the killing of United Healthcare CEO, we have seen a national conversation about health insurance barriers, from delays to denials to the generalization of Americans every day in political scope. Patient frustration.” University of Pittsburgh’s health policy and management.
One such patient is Shelby Kinsey, a 22-year-old Texas resident who was diagnosed with ALS last year. She fought Texas-based insurance company Blue Cross Blue Shield to secure approval for Qalsody, which her doctor said is the most effective treatment for the ALS form.
“When we were first rejected, we were told it was because the Blue Cross Blue Shield in Texas believed that Qalsody was medically unnecessary,” said Jinsey. “We ended up with medical coordination at Baylor Medical College.” The decision was proposed three times with the help of the officer.”
She added: “To be honest, it shocked me that the process is difficult to get approval for parenting medications for diseases that don’t have much choice,” she added.
CNBC contacted Kinsey’s insurance provider, but Texas-based Blue Cross Blue Shield said “no membership issues were discussed with the media.”
Despite the many headlines and Report To point out the increase in health insurance claims denials, the system’s decentralized nature makes it difficult to obtain exact counts.
“It’s hard to estimate exactly how many claims a health insurer rejects in a given year, because not all health insurers report that data. But we do know something.” “The Affordable Care Act takes some effort , to help make this truly complex negative insurance process more transparent.”
She said when insurance companies regulate rejection of patients under the Affordable Care Act, they must give reasons and disclose information about the rejection, and there must also be an appeal process.
“But, like many stories of American law and policy, a lot of them depend on law enforcement,” she added.
Using limited data, KFF, a nonprofit focused on health policy, has published January research It shows that 73 million of the 392 million in-network claims rejected in the United States in 2023. In 2021, 48.3 million of 291.6 million online claims were rejected.
It is worth noting that most consumers will not refuse to reject: less than 1%, and insurance companies maintain 56% of these appeals.
“One of the things we’ve seen in some of the investigation efforts we’ve done in surveying consumers of different types of insurance is that they simply don’t know they have an appeal,” KFF’s Patient and Consumer Protection Program. “If the appeal is used more frequently, it may serve as an inspection for the inspector operator. However, from what we can see now, few people have appealed, so it does not serve as an inspection.”
Watch the video Explore the rise in claims denials, how Americans challenge insurance companies and the current state of health care in the United States
