BOCA RATON, FL – At 4:49 p.m. on a Friday, when clinical judgment traditionally gives way to survival instincts, a primary care physician opened the chart of a patient with … Read more
HENDERSONVILLE, TN: The clinic did not announce the decision with balloons or a press release. It simply stopped taking Medicare Advantage plans, updated the website, and waited for consequences. What … Read more
PALM BEACH, Fla. — Several leading insurance executives met with the President this week at Mar-a-Lago to discuss healthcare access, affordability, and what one attendee described as “the general concept … Read more
INDIANAPOLIS, IN – BlueChoice Health announced this week that it is launching Same-Day Denials™, a breakthrough program designed to improve the member experience by delivering fast, clear answers to coverage … Read more
A mindless denial An insurance executive confirmed this week that a lifesaving treatment was canceled after a routine utilization review revealed the patient had not completed a required trial of … Read more
Effective Date: ImmediatelyApplies To: Utilization Management, Prior Authorization, and All Parties Capable of Remembering Things 1. Purpose The Requester Integrity Standard (RIS-01) establishes uniform requirements for obtaining documentation during the … Read more
— CoveragePending.com Investigative Desk (Est. 3 a.m., fueled by cold coffee and righteous indignation) In a groundbreaking study released this week—after three years of peer review, two appeals, and one … Read more