AMA ilowa nawo mlandu wotsutsana ndi Cigna’s insurance billing practices

Fayilo ya khothi imanena kuti mlanduwu ukhoza kukhudza zikwi za odwala ndi othandizira.

Bungwe lotsogola lazachipatala likukangana ndi m’modzi mwa mabungwe akuluakulu a inshuwaransi mdziko muno pamkangano wamalamulo okhudza ngongole za inshuwaransi.

Bungwe la American Medical Association (AMA) lidalengeza sabata ino kuti lilowa nawo mlandu wotsutsana ndi Cigna. Dandaulo likunena kuti kampani ya inshuwaransi yazaumoyo idalipira ndalama zochepa zomwe odwala amalipira, kuphwanya zomwe akufuna, komanso Federal Employee Income Insurance Act ya 1974, yomwe imakhazikitsa miyezo yocheperako pamapulani ambiri opuma pantchito komanso azaumoyo m’makampani apadera.

kupita kukhoti

Mlanduwu udaperekedwa mu June ku Khothi Lachigawo la US ku Connecticut ndipo udakhala nkhani yankhani zambiri. Ogwira ntchito ku Cigna sanayankhe mafunso omwe adafunsidwa pa Seputembara 15 pankhaniyi azachuma azachipatala.

Dandaulo, lofalitsidwa ndi Classaction.org, linati Cigna adalowa mgwirizano ndi opereka chithandizo chamankhwala oposa 1.2 miliyoni kudzera mu MultiPlan Corp., “network yachitatu” yaikulu kwambiri m’dzikoli.

Othandizira omwe akutenga nawo gawo, omwe amadziwikanso kuti opereka chithandizo mkati mwa netiweki, avomereza kuvomera chiwongola dzanja chodziwika cha chindapusa ngati malipiro athunthu. Dandaulo linanena kuti sangasunge odwala chifukwa cha kusiyana pakati pa chiwongola dzanja choyambirira ndi mtengo wotsitsidwa.

Koma mlanduwu ukunena kuti Cigna adayendetsa molakwika madandaulo a inshuwaransi ya odwala kuchokera kwa omwe adatenga nawo gawo pogwiritsa ntchito njira zobwezera zotsika kwa omwe sanatenge nawo gawo kapena omwe alibe intaneti. Izi zapangitsa kuti anthu azidandaula za malipiro ochepa komanso, kwa odwala, kuwopseza kubweza ngongole ndi opereka chithandizo chamankhwala, mlanduwo unatero.

Odwala atatu omwe adasumira mlanduwo adati adakwana madola masauzande ambiri kuti achitepo opaleshoni ya msana, maopaleshoni ovuta a mafupa ndi opaleshoni yomanganso mawere atalandira chithandizo cha khansa ya m’mawere.

Onse adagwiritsa ntchito ndondomeko ya inshuwaransi yaumoyo yamkati. “Ma apilo onse adathetsedwa,” adatero mlanduwo, ndikuwapatsa ufulu woti athetse vuto lawo kudzera m’khoti.

Ngakhale kuti chiwerengero chenicheni cha odwala omwe akukhudzidwa sichidziwika, maloya a odandaulawo akuyembekeza kuti izi ziphatikizepo zikwi za anthu omwe ali ndi inshuwalansi. Mbiri ya Cigna sinatchule nambala yeniyeni ya inshuwaransi, koma adati kampaniyo ili ndi makasitomala 17 miliyoni azachipatala padziko lonse lapansi.

Madokotala amachitapo kanthu

Jack Resnick, pulezidenti wa AMA, adadzudzula chimphona cha inshuwaransi yazaumoyo chifukwa cha “zolakwika … zodzaza ndi mikangano yachidwi komanso chinyengo chomwe chafupikitsa malipiro kwa MultiPlan Doctors.” Iye adati kampaniyo idasokoneza ubale wa dokotala ndi wodwala polankhula zolakwika za ndalama zomwe odwala ayenera kulandira pachipatala.

“Odwala ndi madokotala ali ndi ufulu woyembekezera ma inshuwaransi kuti akwaniritse lonjezo lawo lopereka malipiro oyenera komanso olondola pa chithandizo chamankhwala.” Koma zolakwa zomwe Cigna adawaganizira zinapangitsa kuti kampani ya inshuwaransi ikhale yodzikonda pazachuma kuposa zomwe idalonjeza madokotala mu MultiPlan Network. ndi odwala awo,” adatero Resnick. “Pogwirizana ndi Stewart v. Cigna monga wodandaula, AMA ikuyembekeza kuwunikira khalidwe loipa la Cigna ndikupanga mankhwala kuti odwala ndi madokotala athe kuyembekezera kupeza zomwe adalonjeza.”

Kupatula AMA, Washington State Medical Association ndi New Jersey Medical Association alowa nawo chifukwa.

“Ndi mlanduwu, wonena kuti Cigna adalipidwa molakwika kwa madokotala, tikuyembekeza kubweretsa zolakwa zilizonse za Cigna ndikuziletsa, ndikulimbikitsanso mayankho omwe amapindulitsa odwala ndi azachipatala,” adatero. Kuchokera kwa Purezidenti wa MSNJ Stephen Orland, MD. MSNJ ikupitilizabe kuthandizira ntchito zonse zomwe zikugwirizana ndi cholinga chathu – ndife onyadira kulowa nawo AMA ndi Washington State Medical Association poyesetsa kulimbikitsa thanzi labwino la anthu, kwinaku tikuchirikiza ufulu wa odwala ndi madotolo, kuno ku New Jersey ndi kudutsa. dziko.”

Leave a Comment

Your email address will not be published.