Doctors at a major US insurance company deny tens of thousands of claims a month without even looking at patients’ files.

“We literally click & submit,” a former Cigna doctor told @ProPublica & The Capitol Forum. “It takes all of 10 seconds to do 50 at a time.”

The inside story 🧵

2/ Nick van Terheyden was puzzled when Cigna told him it wouldn’t cover the cost of a simple blood test, which it deemed “not medically necessary.”

“This was a clinical decision being second-guessed by someone with no knowledge of me.'

3/ Nick's unease was justified. His claim was just one of ~60,000 rejected in just a month by Dr. Cheryl Dopke, a Cigna-employed medical director responsible for deciding whether patient claims will be paid or rejected.
propublica.org/article/cigna-…

4/ And Dopke wasn't alone. A review of internal Cigna records turned up multiple medical directors who were rejecting a large volume of claims. Here are the Jan. 2022 rejection stats for 3 Cigna-employed doctors: