Not Medically Necessary Inside the Company Helping Americas Biggest Health Insurers Deny Coverage for Care
News Source : Scheerpost.com
News Summary
- EviCore uses an algorithm backed by artificial intelligence that it can adjust to lead to higher denials
- Some contracts ensure the company makes more money the more it cuts health spending
- Some medical groups have repeatedly complained that EviCore’s guidelines were outdated and resulted in inappropriate denials or delays in care
In 2021, EviCore turned down a doctors request to cover a cardiac exam for Little John Cupp, right. He was a constant presence in the lives of his daughter Chris, left, and granddaughter Theresa, cen [+25820 chars]
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