‘Not medically necessary': Inside the company helping America's biggest health insurers deny coverage for care [CNN]
Elevance Health, Inc. (ELV)
Company Research
Source: CNN
But the insurance companies don't always make these decisions. Instead, they often outsource medical reviews to a largely hidden industry that makes money by turning down doctors' requests for payments, known as prior authorizations. Call it the denials for dollars business. The biggest player is a company called EviCore by Evernorth, which is hired by major American insurance companies and provides coverage to 100 million consumers — about 1 in 3 insured people. It is owned by the insurance giant Cigna. A ProPublica and Capitol Forum investigation found that EviCore uses an algorithm backed by artificial intelligence, which some insiders call “the dial,” that it can adjust to lead to higher denials. Some contracts ensure the company makes more money the more it cuts health spending. And it issues medical guidelines that doctors have said delay and deny care for patients. EviCore and companies like it approve prior authorizations “based on the decision that is more profitable f
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ELV
News
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- Investors Will Want Elevance Health's (NYSE:ELV) Growth In ROCE To Persist [Yahoo! Finance]Yahoo! Finance
- OPEN MINDS & Qualifacts Partner on Data Innovation Masterclass Live on December 4 [Yahoo! Finance]Yahoo! Finance
- Elevance Health, Inc. Shareholders are Encouraged to Reach Out to Johnson Fistel for More Information about Potentially Recovering Their LossesGlobeNewswire
- Insiders At Elevance Health Sold US$12m In Stock, Alluding To Potential Weakness [Yahoo! Finance]Yahoo! Finance
ELV
Earnings
- 10/17/24 - Miss
ELV
Sec Filings
- 11/14/24 - Form SC
- 11/5/24 - Form 4
- 11/5/24 - Form 4
- ELV's page on the SEC website