this post was submitted on 04 Dec 2024
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UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges

https://arstechnica.com/health/2023/11/ai-with-90-error-rate-forces-elderly-out-of-rehab-nursing-homes-suit-claims/

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[–] aramis87@fedia.io 88 points 2 weeks ago (5 children)

I have never had worse "insurance" than when I had United "Healthcare". They have you a big book full of all their "providers", but when you called to make an appointment, you were told they'd left United quite a while back and shouldn't be in the book. A few providers were still in network, but they weren't accepting new patients. Their "provider support" line was completely useless, because they would only read you out the "options" available in the book, the one with all the ghost providers.

My SIL in southern New Jersey ended up with them for some reason. She needed to see an OB/Gyn due to some abnormal bleeding that had been going on for too long. She went through their provider carousel and finally found one provider who was still in network and also still accepting new patients. That provider was 2.5 hours away from her, in the very other end of New Jersey.

I eventually did find one local provider who was in network, except they never did any comprehensive medical visits; you had to visit them for one issue at a time, at least a week apart. They'd give you a prescription or a referral but (once again) you were entirely on your own finding someone to accept the referral. Like there were times I'd make a dozen phone calls a day for weeks, trying to find someone who could see me - it was very much an entire part-time job trying to see someone!

I ended up switching insurance and have ended up 'captured' within a regional hospital's provider network. The hospital bought up a bunch of local independent providers in all the different specialities. I'm really unhappy with the continued corporatization of healthcare and the conglomeration of hospital networks - but the ability to call one number, be given a specialist within reasonable driving distance and (in that same phone call) be given an appointment within a reasonable timeframe is just so refreshing!

[–] kreskin@lemmy.world 33 points 2 weeks ago* (last edited 2 weeks ago) (2 children)

I was told by my nexyt door neighbor doctor that they pay doctors such abysmally low rates that no doctor wants to take their patients. It seems like a scheme to collect premiums and not render any care for members. And its one of the largest health care companies in the US.

[–] aramis87@fedia.io 11 points 2 weeks ago (1 children)

I'm pretty sure that's why that one doctor would only go over one issue per visit.

[–] chuymatt@startrek.website 7 points 2 weeks ago

With Molina, we would lose $30 by the time that the patient got in the room. We had to drop them as they refused to reimburse any better, even through all the inflation of everything else.

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