$UNH United sued last week acknowledged they HAVE TO PAY FOR COVID TESTING PERFORMED BY PHYSICIANS. UNITED refused to pay physician labs for YEARS. Now they recognize that the FFCRA and CARES mandate they pay these physicians and their labs! @EdGainesIIImodernhealthcare.com/insurance/unit…
This is precisely the problem. The lawsuit is about demanding proof of each & every test done. Then you submit this and they deny for “improper physician order” This letter is meant to stave off thousands of lawsuits from work in 2020. IT WONT WORK. Providers are getting lawyers.
Insurers are violating federal law. They know it. Cigna admits it, but says, so what doctor? You can’t do anything about it! @wendellpotter Instead they accuse of fraud because that’s their “loophole” here. It will cause massive problems when they just should’ve paid.
Instead they just made wild profits, enjoyed stock bumps, paid executives and cut payments to labs and physicians. @UncoveredHealth details all of these games. So if a magnanimous letter saying they’ll pay at a level which most providers will have a loss…testing won’t be there.
Don’t believe they had wild profits? Let me tell you they did. Think it’ll come back to you as rebates? Think again, they’ve managed to manipulate that too. insurancenewsnet.com/innarticle/hea… And unlike Progressive Car insurance. Healthcare rates are going up no matter what
Most everyone will see increases? Why? Because insurers need to take money from employees, employers and pay their executives and shareholders. While graciously paying Medicare rates for tests that they are mandated by federal law to pay. If OON at the rates charged by the doc.
This is a shot of me in CT running the line with police assistance. The demand for testing was huge. Everyone was scared. We were the first to do testing via drive through on the east coast. Hundreds of labs and docs followed our lead. We wrongly assumed we would be paid
If doctors and labs can’t get paid, they’ll stop testing. That’s the most dangerous thing that can happen in this pandemic. If we can’t test, we can’t do the rest. #covid19#pandemic
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#polybio #longcovid take aways so far? It appears academia is catching up to the theories that doctors like myself are already treating for. This is good.
#longcovid is anyone live tweeting this?
Altered germinal center responses vs Convalescent. Small numbers of individuals it appears which limits discovery.
I used #ChatGPT4 to appeal #Medicare claims to a judge. Here’s how a 🧵
Step one ask “As you are knowledgeable in medical billing, with your expert opinion give me the step by step process to appeal a Medicare claim at all levels”
This will produce a list for each step. Most people don’t know, there are 5 levels of hell (appeal) for a denied Medicare claim. Who denies these? Well, NOT MEDICARE. They outsource it to low level business people AKA MEDICARE ADMINISTRATIVE CONTRACTORS (MACs)incentivized to deny claims. In this case @NGSMedicare You can find your MAC by looking on this website
A lovely little $CI @Cigna thread. Just when you think they can’t get more mafia. Read this little gem. At appeal is a COVID-19 test #COVID19 was mandated to be covered during the pandemic by Congress. Watch @michaelcburgess and @FrankPallone clarify this. @FrankPallone confirms
NO COST FOR COVID TEST AND SERVICE TO THE PATIENT. So, why charge the patient when the law says no cost? Well apparently, if a patient can receive services at NO COST, CIGNA won’t pay. Despite the law mandating coverage for COVID-19 tests during the pandemic. Read closely
There is no coverage for charges that would not have been billed if the person had no insurance and/or
Oh @ConnectiCare Why are you breaking the law? Again and Again. In this case you literally denied due to timely filing. I talked about this since I discovered it in May. So @USDOL are you ever going to enforce these? They literally responded today on the… https://t.co/obVO4gEdAs https://t.co/nZdl19Od9a
It’s not only them $UNH getting in on the game. Responding July 8th but dating it July 10th. We see your games. Does @USDOL @UHC ? @DGlaucomflecken ? Either I travelled to the future or you dated this 7/10/23 to try and game the rules.
@USDOL @UHC @DGlaucomflecken No I am not traveling back to the future 🏎️ $UNH DATED THIS JULY 11th 2023. @USDOL are you paying attention to these games? Today is July 8th. Can you believe this @EdGainesIII ? What about you @mass_marion ?
Hey @propublica here’s a story about a company named $CI using #AI DENIAL BOTS TO DENY COVID 19 TESTS. Mind you FFCRA & CARES ACT mandated covid test payments. I won’t review the law here but suffice it to say @Cigna has violated federal law here. Patients have sued $CI and we… twitter.com/i/web/status/1…
But here is where the plot gets interesting @Cigna uses medical management decision to deny a federally mandated and @US_FDA APPROVED COVID-19 test called @BioFireDX using Medical Coverage Policy 0530. Yes, Yes insurer violating Federal law while @USDOL or @HHSGov doesn’t hold… twitter.com/i/web/status/1…