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#evernorth — Public Fediverse posts

Live and recent posts from across the Fediverse tagged #evernorth, aggregated by home.social.

  1. Ripple Ally Evernorth Seals $1B XRP Treasury Deal Ahead of Nasdaq Debut - TLDR:

    Evernorth’s $1B merger with Armada will create the largest XRP treasury fir... - blockonomi.com/ripple-ally-eve #evernorth #finance #fintech #armada #crypto #nasdaq #ripple #xrp

  2. “Not Medically Necessary”:

    Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care

    Every day, patients across America crack open envelopes with bad news.
    Yet another health insurer has decided not to pay for a treatment that their doctor has recommended.
    But the insurance companies don’t always make these decisions.
    Instead, they often outsource medical reviews to a largely hidden industry
    that makes money by turning down doctors’ requests for payments, known as #prior #authorizations.
    Call it the denials for dollars business.

    The biggest player is a company called #EviCore by #Evernorth, which is hired by major American insurance companies
    and provides coverage to 100 million consumers
    — about 1 in 3 insured people.
    It is owned by the insurance giant #Cigna.

    A ProPublica and Capitol Forum investigation found that
    EviCore uses an algorithm backed by artificial intelligence,
    which some insiders call “the dial,”
    that it can adjust to lead to higher denials.

    Some contracts ensure the company makes more money the more it cuts health spending.
    And it issues medical guidelines that doctors have said delay and deny care for patients.

    EviCore and companies like it approve prior authorizations
    “based on the decision that is more profitable for them,” said Barbara McAneny, a former president of the American Medical Association and a practicing oncologist.
    “They love to deny things"

    propublica.org/article/evicore