@UncoveredHealth profile picture
Un-covered @UncoveredHealth

An initiative designed to expose how payors have put their corporate wealth over the nation’s health—at the expense of patients and providers alike.

Joined November 2020
  • Tweets 277
  • Following 8
  • Followers 776
221 Photos and videos
What can hospitals like @DignityHealth do when insurers refuse to play fair? @BCBSAZ has split with the health system’s Arizona locations. Here’s why: uncovered.health/evidence/an…

Another payor-provider breakup - Un-covered

As of February 1, Blue Cross Blue Shield of Arizona (BCBSAZ) is out of network with San Francisco-based Dignity Health’s Arizona locations.

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State health plans are a big deal. But is @BCBSNC’s lawsuit over losing the state health plan in the best interest of North Carolinians? We don’t think so: uncovered.health/evidence/pr…
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In a system set up to benefit payors, an increasing number of providers are baffled that health insurers aren’t paying under the #NoSurprisesAct. Learn more: uncovered.health/evidence/no…

No surprises here: Insurers failing to uphold their end of the No Surprises Act - Un-covered

In a system meant to benefit payors, an increasing number of providers are baffled that insurers aren’t paying under the No Surprises Act.

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‘I came, I saw, I conquered.’ At least, that’s what we imagine @BlueCrossNC said after it acquired all of North Carolina’s @FastMedClinics locations. The state’s largest health insurer has big plans for growth, but what’s the impact on patients? Read more: uncovered.health/evidence/he…

Hey North Carolina, be wary of BCBSNC’s growth plan. - Un-covered

More than processing premiums and paying out claims, more health insurers like BCBSNC are infiltrating the healthcare delivery market.

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A new investigation found that at least a dozen doctors were hired by insurance companies after being disciplined by state medical boards or making malpractice payments. Now, they decide whether your healthcare services are “medically necessary.” uncovered.health/evidence/so…

Some insurance companies employ doctors with medical malpractice suits to review claims. - Un-cov...

Where do doctors with malpractice suits go? In some cases, to insurance companies, where they review and make decisions about your care.

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Oops, they did it again. @Humana is the latest insurer to face a lawsuit over its use of AI in claims processing. Here’s what happened: uncovered.health/evidence/ye…

Yet another health insurance company is using AI to deny medical claims. - Un-covered

A new lawsuit alleges that Humana is using an AI model to improperly deny care to Medicare Advantage patients.

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The deal is back from the dead! @ElevanceHealth 's $2.5 billion acquisition of @BCBSLA would require the latter to become a for-profit insurer. Here’s why regulators—and consumers—should still be worried: uncovered.health/evidence/an…

An insurance merger is back from the dead—but who benefits? - Un-covered

Elevance Health's $2.5 billion acquisition of Blue Cross and Blue Shield of Louisiana is back on. But who benefits? Not consumers.

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Health insurance companies continue to use claim denials to preserve profits as they avoid paying for care. And despite state regulations, insurers’ actions seem to communicate that “We don’t care.” Read more: uncovered.health/evidence/we…

We don’t care, say insurers: Payors bypass state laws and deny care. - Un-covered

States have enacted hundreds of laws that determine what insurers must cover. But covered services are still being denied.

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It’s the battle of the PBMs: David and Goliath edition. Some smaller companies are trying to get in on the action of the PBM market. Will they provide the PBM reform that they promise? Call us skeptical: uncovered.health/evidence/it…

It’s the battle of the PBMs. - Un-covered

Some smaller companies are trying to get in on the action of the PBM market. Will they provide the PBM reform that they promise?

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Because of increased government scrutiny, some #healthinsurers just might feel the need to do some #priorauthorization cleanup before they’re hit with more regulations or fines. Here’s why providers are skeptical: uncovered.health/evidence/pr…

Prior authorization reform? We’ll believe it when we see it. - Un-covered

Even though insurers are promising to cut back on prior authorization requirements, providers are skeptical.

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According to new data, the more health challenges you experience, the more likely it is that you’ll face claim denials. Wondering how that helps patients get better? We are, too. uncovered.health/evidence/th…

The data keeps rolling in — claim denials continue to impact patient care - Un-covered

Insurance companies continue to cook up strategies to shortchange health systems through underpayments, non-payments, and claim denials.

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Is paying private companies to manage #Medicare plans worth it anymore? Insurance companies keep finding ways to squeeze more dollars out of the program, but it’s not necessarily benefiting patients. Read more: uncovered.health/evidence/in…

Insurance companies continue to squeeze dollars out of Medicare Advantage - Un-covered

Let’s say you run a big, unwieldy, expensive government program. You want to trim costs, but your program provides services in all 50 states for more than 65 million Americans, and you… Read More

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It’s that time of year again — #insurers are releasing their 2024 premium rates. And you can count on insurers deflecting blowback from their rate hikes by blaming anyone but themselves. Exhibit A — North Carolina: uncovered.health/evidence/de…

Deflecting blame is an insurer’s specialty - Un-covered

Health insurance premiums go up, and insurer lobbyists like Peter Daniel find anyone to blame but . . . insurers.

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Claim denials have morphed into a profit-saving methodology benefiting big insurance companies and harming patients. Here’s how many insurers denied claims in 2021: uncovered.health/evidence/ex…

Expect to be denied: Claim denials are on the rise - Un-covered

Claim denials have morphed into a profit-saving methodology benefiting commercial insurers more than patients.

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Whether it’s electronic payment processing fees or pharmaceutical negotiations, find out how payor lobbyists find creative ways to skim dollars off the top for insurance companies, while making patient care harder for providers: uncovered.health/evidence/do…

Doctors are slapped with fees when opting for electronic funds - Un-covered

Whether it’s electronic payment processing fees or pharmaceutical negotiations, lobbyists find opportunities to make health insurers money.

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Will speaking out online against your health insurance company make a difference in getting your claims paid? It did for Sally Nix. Here’s why people like Nix are increasingly turning to the internet to get justice from their health insurer: uncovered.health/evidence/do…

Doctors and patients are getting loud online. Here’s why. - Un-covered

Will speaking out online against your health insurance company make a difference in getting your claims paid? It did for Sally Nix.

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The data released by the @ahahospitals speaks to an overarching pattern in the American healthcare system: commercial health insurers getting in the way of critical medical care, jeopardizing patient health and frustrating providers in the process: uncovered.health/evidence/an…

Another survey reveals the dark underbelly of commercial health insurers - Un-covered

According to three new surveys, patients, nurses, and physicians are none too happy with health insurer policies and practices.

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Physician groups are lobbying. Patients are protesting. Lawmakers are proposing legislation to Congress. Here’s why #priorauthorizations are a bureaucratic bad idea: uncovered.health/evidence/pr…

Prior authorizations are (still) a bad idea. - Un-covered

While prior authorizations can be a minor inconvenience for some, they can have dire consequences for others.

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@UnitedHealthcare’s new policy hopes to reduce unnecessary colonoscopies. But in our minds, the bigger risk isn’t unneeded screenings, but undetected cancer. Here’s why you should be concerned: uncovered.health/evidence/un…

UnitedHealthcare rolled back its prior authorization policy. But ‘advance notification’ might be...

UnitedHealthcare made some changes to their (already troublesome) prior authorization policy. What they came up with isn’t much better.

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According to a report from @ahahospitals , one of the main reasons for the sudden rise in hospital expenses is the high burden of administrative costs from billing and insurance. Get the scoop: uncovered.health/evidence/ho…

Hospitals are struggling as costs rise. Insurers aren’t helping. - Un-covered

Hospital costs – supplies, labor, utilities – keep going up. And insurers aren’t helping. Will hospitals go under?

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