Not Medically Necessary Inside the Company Helping Americas Biggest Health Insurers Deny Coverage for Care

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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  • Some medical groups have repeatedly complained that EviCore’s guidelines were outdated and resulted in inappropriate denials or delays in care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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