STAT

NOVEMBER 14, 2023

For more than a year, our reporters have documented how the use of artificial intelligence is driving denial of claims or delaying treatment for seriously ill patients. This latest story goes even deeper, establishing how the denial of claims was by design.

Health Insurance Companies 124

Health Insurance Companies Documentation Insurance 124

STAT

NOVEMBER 14, 2023

The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found.

Health Insurance Companies 145

Health Insurance Companies Insurance Documentation 145

STAT

JULY 10, 2024

This document is where the government has in the past rolled out changes to the so-called hospital price transparency rule, but the Biden administration did not address the issue in this edition. Since 2021, hospitals have been required to post the prices they have negotiated with all health insurance companies, as well as their cash prices.

Hospitals 122

Hospitals Health Insurance Companies Documentation Insurance 122

STAT

JANUARY 30, 2023

The federal government and health insurance companies have been clashing for more than a decade over how Medicare Advantage plans should be audited and how the well-documented overpayments to those plans should be clawed back.

Health Insurance Companies 113

Health Insurance Companies Insurance Documentation 113

The Checkup by Singlecare

DECEMBER 26, 2023

How much does an MRI cost without insurance? According to Michael Yudelevich, MD , an independent patient advocate at My Personal Health Advocate in New York City, an MRI can range from $400 to $12,000. You may have to pay the full price if you don’t have health insurance. How much does an MRI cost with insurance?

Insurance 64

Insurance Insurance Coverage Hospitals Mayo Clinic 64

The Checkup by Singlecare

SEPTEMBER 7, 2023

Step therapy focuses on using cost-effective treatments for various conditions, which may help save money in the long run for insurance companies and the people they cover. Step therapy is a process used by health insurance companies to manage and control prescription drug costs. What is step therapy?

Insurance 97

Insurance Health Insurance Companies Documentation Communication 97

pharmaphorum

JANUARY 27, 2023

While SaveOnSP is the nominal target of the lawsuit, it claims to expose one of the failings in the US health insurance sector, adding fire to an increasingly heated exchange between pharma manufacturers and pharmacy benefit managers (PBMs), which have blamed each other for high medicine prices in the US.

Specialty Pharmacies 105

Specialty Pharmacies Insurance Health Insurance Companies Documentation 105