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A comment on "Not Medically Necessary": Helping America's Health Insurers Deny Coverage. Parent comment

Re:"Not Medically Necessary": Helping America's Health Insur... by vjvjvjvjghv on Wednesday May 13, 2026 @05:38PM (#48127976)
“ I just started approving everything. "Patient needs emergency surgery for X" "Approved".”

Did they ding you for bad performance after a while? Your job was to maximize denials, not approvals.

[ Parent | on HN ]
Re:"Not Medically Necessary": Helping America's Health Insur... by tempaccount5050 on Wednesday May 13, 2026 @07:43PM (#48129194)
I didn't stay long enough to find out, but yeah, they probably would have. The pressure was definitely to default to deny it. That's what the run books (very few) were defaulted to. It was really just a bunch of expendable people to deny claims. The turnover was wild for obvious reasons.
[ Parent | on HN ]