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nH Predict is a computer program developed by naviHealth that implements an algorithm that has allegedly been used by health insurance companies including United Healthcare and Humana [1] [2] to automatically deny coverage to patients. [3] [4] [5] It is reported to work by cross-correlating patient health records with those of other patients. [6]
There have been examples over the years of insurers handling the denials callously to avoid having to pay out the claim. Only 0.2% of denied claims are appealed by patients.
Brian Robert Thompson [1] [2] (July 10, 1974 – December 4, 2024) was an American businessman who was the chief executive officer (CEO) of UnitedHealthcare, the insurance arm of UnitedHealth Group, from April 2021 until his killing in December 2024.
UnitedHealthcare has repeatedly faced criticism for its approach to handling claims. [31] It and other insurers were named in an October 2024 report from the United States Senate Homeland Security Permanent Subcommittee on Investigations showing a surge in prior authorization denials for Medicare Advantage patients. [28]
Whether the public outcry prompts UnitedHealthcare and other insurers to adjust their practices — particularly the much-maligned denials of treatment and claims — or pushes lawmakers to force ...
One significant issue is the rise in claim denials. A 2024 report by Experian Health indicates that denials have been increasing year over year, with authorization issues and incorrect information ...
Delay, Deny, Defend is a critical exploration of the property and casualty insurance industry, examining how its practices affect policyholders.Feinman, a law professor specializing in consumer rights and insurance law, argues that the industry prioritizes profits over policyholders' needs, often using tactics like delaying or denying legitimate claims to bolster financial performance.
The majority of insured US adults had at least one issue, including denial of claims, with their health insurance in the span of a year, according to a survey released in June 2023 by KFF, a ...