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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]
Veterans' health care in the United States is separated geographically into 19 regions (numbered 1, 2, 4–10, 12 and 15–23) [1] known as VISNs, or Veterans Integrated Service Networks, into systems within each network headed by medical centers, and hierarchically within each system by division level of care or type.
It originally processed claims for doctors at the Hennepin County Medical Society. [5] UnitedHealthcare Corporation was founded in 1977 to purchase Charter Med and create a network-based health plan for seniors. [6] It became a publicly traded company in 1984 and changed its name to UnitedHealth Group in 1998. [7]
A UnitedHealthcare letter is shown. UnitedHealth Group is being sued for allegedly using an artificial intelligence algorithm to systematically deny elderly patients rehabilitative care.
Seal of the United States Court of Appeals for the Federal Circuit. Veterans advocacy organizations such as Disabled American Veterans (DAV) and the National Organization of Veterans' Advocates (NOVA) [8] have argued that many additions to the M21-1 Manual constitute "interpretative rules" and that the Federal Circuit therefore has jurisdiction to review such changes upon direct appeal by a ...
The United States Court of Appeals for Veterans Claims is commonly referred to as the Veterans Court, USCAVC, or simply CAVC. The court was previously known as the United States Court of Veterans Appeals, but was changed to the current name by the Veterans Programs Enhancement Act on March 1, 1999 (Pub.L. No. 105-368). [3]
The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
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