The Human Cost of Automated Health Claims: A Struggle for Coverage (WYMT)

The Human Cost of Automated Health Claims: A Struggle for Coverage

  Tuesday, November 28th, 2023 Source: WYMT

Amanda Bredlow’s battle with her health insurer, Cigna, over denied fertility treatment claims reveals a deeper issue: the impersonal nature of automated insurance claim processing. Despite following guidelines and numerous appeals, Bredlow’s claims were repeatedly denied, leading to immense financial and emotional strain. The insurer’s alleged use of a computer program, "PXDX," to process claims has sparked multiple lawsuits, including a class action in California. Critics argue that this approach lacks a human touch and fails to consider individual patient needs, leading to wrongful denials. As the healthcare industry increasingly leans on technology, questions arise about the balance between efficiency and the essential human element in healthcare.

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