You Snooze, You Lose . . .

[somarco]

UnitedHealth argues algorithm lawsuit should be dismissed because patients didn’t spend years appealing denials.

UnitedHealth Group should be released from a lawsuit that alleges its algorithm-based technology prematurely cut off care to its Medicare Advantage members, the company said in court filings this week, because patients and their families did not finish Medicare’s appeals process.

“Plaintiffs have failed to exhaust the exclusive administrative appeal process set by the Medicare Act,” UnitedHealth’s lawyers argued. Even if those requirements were met, they added, the grievances of patients and families are with the federal government, not UnitedHealth and its subsidiary NaviHealth. “The plaintiffs have sued the wrong defendants,” the filing states.

UnitedHealth argues algorithm lawsuit should be dismissed because patients didn’t spend years appealing denials

UnitedHealth Group argued it should be released from a lawsuit that alleges its algorithm-based technology prematurely cut off care to its Medicare Advantage members.

www.statnews.com

 

[Yagents]

"The patients dog ate the appeal letter" would be more convincing

 

[vic120]

Hmm so if they contact you about a prospects allegation can you use the same logic?

 

[Newby]

My personal experience with them is the lawsuit needs to continue. They have not paid a single penny on two very legit hospital stays I had last year. I’ve paid huge premiums to them for 15-years and always assumed I had great coverage until I had my first serious health issues last year.

 

[somarco]

They have not paid a single penny on two very legit hospital stays I had last year. I’ve paid huge premiums to them for 15-years and always assumed I had great coverage until I had my first serious health issues last year.

According to the article, they are denying claims because the policyholder quit trying to get the claim paid.

Sounds like they believe they are above the law (contract law).