When companies like Aetna or UnitedHealthcare want to rein in costs, they turn to EviCore, whose business model depends on turning down payments for care recommended by doctors for their patients.
  • peeonyou [he/him]@hexbear.netEnglish
    12·
    2 months ago

    you mean to tell me United Healthcare learned nothing?

    also interesting that Evi(l)Core lists the following on their own website:

    EviCore Headquarters
730 Cool Springs Blvd
Franklin, TN 37067
Driving Directions
Phone: 800.918.8924
  • Evilphd666 [he/him, comrade/them]@hexbear.netEnglish
    5·
    2 months ago

    Dr. Evil, ViruCon has made it’s way into vertically monoploized AI shell companies.

    https://en.wikipedia.org/wiki/EviCore

    As an outsourced medical review company, EviCore reviews claims for procedures, which it approves or denies based on the likelihood of approval as determined by an artificial intelligence algorithm. EviCore was formed by the 2014 merger of MedSolutions, Inc, and CareCore National. It was acquired in 2017 by Express Scripts and in 2018 by Cigna, which operates it through the subsidiary Evernorth. In the 2020s, it has used an artificial intelligence algorithm to review the likelihood of a claim being denied, which has been criticized as being motivated by profit. Medical organizations have criticized the company’s guidelines for delaying or denying treatment.

    …

    In 2024, EviCore was fined $16,000 for 77 charges after a review of 196 files by Connecticut’s Insurance Department.

    That’ll teach em!

    As of 2024, over one hundred insurance companies outsourced utilization review to EviCore, including Aetna, Blue Cross Blue Shield, and UnitedHealthcare, as well as some states’ Medicaid programs…EviCore is the largest prior authorization company in the United States; it provided services for over 100 million people in the country, or one-third of people with health insurance, as of 2024.

    https://www.evernorth.com/our-solutions

    Evernorth Health Services, Inc.

    One Express Way, St. Louis, MO 63121

    All products and services are provided by or through operating subsidiaries or affiliates of Evernorth [a Cinga shell company]

    Parody twitter account seemed to stop posting 2022

    https://xcancel.com/evilcoreHealth/with_replies