Un-covered

For Blue Cross Blue Shield of Arizona, all’s not fair in love and war. The insurer’s split with Dignity Health’s Arizona locations underscores American insurers’ blatant disregard for the plight of hospitals. Read more: https://lnkd.in/eZ7CH_xx

Blue Cross NC has been booted . . . from the state health plan, that is. The insurer’s response? Sue the state. But is this lawsuit in the best interest of North Carolinians? We don’t think so. Here’s why: https://lnkd.in/eUf5KqA7

Payors aren’t paying: Under the No Surprises Act, health insurers are required to pay providers within 30 days of a final determination by an arbiter. But an increasing number of payors aren’t playing by the rules, leading to an increasing number of lawsuits. Get the details: https://lnkd.in/ehRcqA8X

More than processing premiums and paying out claims, more and more health insurers are infiltrating the healthcare delivery market. Just ask Blue Cross NC, whose recent acquisition of the state’s FastMed Urgent Care clinics shows a clear growth path for North Carolina’s largest health insurer. Here’s the latest: https://lnkd.in/g8xUnhe9

That doctor hired by your health insurance company to review your medical claim just might have a checkered past. According to a new investigation, at least a dozen doctors were hired by health insurers after being disciplined by state medical boards or making malpractice payments. Now they’re deciding the fate of your medical care. Learn more: https://lnkd.in/dhTMcz6z

#AI is taking the field of healthcare by storm — but it’s not a technology utopia just yet. Humana is in hot water for allegedly using AI to improperly deny care to #MedicareAdvantage patients. Read more: https://lnkd.in/eQ5Pwm8r

Blue Cross and Blue Shield of Louisiana has officially filed a new application with Louisiana’s insurance department to structure itself into a for-profit agency, putting it one step closer to solidifying its merger with Elevance Health. But here’s the problem with for-profit plans—and why their motives are not in the best interest of consumers: https://lnkd.in/ej2QKMTN

Certain states have laws mandating what insurers are required to cover. Unfortunately, many regulatory departments are ill-equipped to monitor compliance. Here’s how health insurers are taking advantage: https://lnkd.in/emHwvzS6

There are some new kids on the PBM block! Some smaller companies are trying to make a name for themselves. While they claim they’ll lower consumer costs, increase price transparency, and hold bigger PBMs accountable, do we trust their promises? Read more: https://lnkd.in/eMyBZxsh

UnitedHealthcare has recently found itself in hot water over an algorithm that seems to deny rehab care for Medicare Advantage beneficiaries. Here’s why the nation’s largest health insurer’s latest antics have left it with a lawsuit: https://lnkd.in/ekQerTWs