CIGNA: Busted PxDx [Procedure-to-Diagnose]

Posted on July 26, 2023 by Dr. David Edward Marcinko MBA

By Dr. David Edward Marcinko MBA CMP

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(AP) — A federal lawsuit alleges that health insurance giant CIGNA used a computer algorithm to automatically reject hundreds of thousands of patient claims without examining them individually as required by California law.

RELATED: https://medicalexecutivepost.com/2022/09/18/ama-joins-class-action-suit-against-cigna/

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The class-action lawsuit, just filed in federal court in Sacramento, says CIGNA Corp. and CIGNA Health and Life Insurance Co. rejected more than 300,000 payment claims in just two months last year.

RELATED: https://medicalexecutivepost.com/2022/07/21/my-conversation-with-an-anonymous-cigna-representative/

The company used an algorithm called PXDX, shorthand for ”procedure-to-diagnosis,” to identify whether claims met certain requirements, spending an average of just 1.2 seconds on each review, according to the lawsuit.

CITE: https://www.r2library.com/Resource

Huge batches of claims were then sent on to doctors who signed off on the denials, the lawsuit said.

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PODCAST: https://medicalexecutivepost.com/2023/07/01/podcast-the-cigna-group-ceo/

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MARKETS & ECONOMY …. Oh My?

Posted on July 26, 2023 by Dr. David Edward Marcinko MBA

By Staff Reporters

MICRO-CERTIFICATION SPONSOR: https://tinyurl.com/5n7jxxzb

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  • Markets: The Dow is on a run for the ages, extending its winning streak to 12 days. But, Spotify revealing widening losses due to its failed podcasting investments and projected lower revenues. And its stock plunge came despite adding a record number of new subscribers.
  • Economy: All eyes are on the FOMC today: With another rate hike pretty much a lock, investors will seek Jerome Powell’s comments to see whether the Fed is considering any more increases.

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  • Alphabet, which declared a “code red” for Google Search late last year as rivals like ChatGPT and Microsoft’s AI-equipped Bing came on the scene, is chugging right along. Google’s search advertising sales grew to a better-than-expected $42.6 billion. And, most people haven’t made ChatGPT their default search engine.
  • Microsoft beat expectations on its top- and bottom lines and told investors that it had spent, and would continue spending, gobs of money to build out AI infrastructure.

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Snap. The social media platform just rolled out an AI chatbot, My AI, and boasted that 150+ million users have sent over 10 billion messages to it. But, still fighting against the likes of TikTok for ad spending in a sluggish market, Snap’s sales dropped for the second straight quarter, causing shares to plummet 19% after-hours.

Conference calls: Meta reports earnings today, and Amazon and Apple report next week.

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DAILY UPDATE: Google CFO and the Markets

Posted on July 26, 2023 by Dr. David Edward Marcinko MBA

By Staff Reporters

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Google Chief Financial Officer Ruth Porat will become president and chief investment officer of parent company Alphabet, ending an eight-year run during which she helped pitch the company to Wall Street.

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Here is where the major benchmarks ended yesterday:

  • The S&P 500 Index was up about 13 points (0.28%) at 4,567.46; the Dow Jones Industrial Average was up about 27 points (0.08%) at 35,438.07; the NASDAQ Composite was up 86 points (0.61%) at 14,144.56.
  • The 10-year Treasury note yield (TNX) was little changed at 3.883%.
  • CBOE’s Volatility Index (VIX) was up 0.09 at 14.00.

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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