EviCore by Evernorth: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care

https://archive.ph/cXPRQ

EviCore by Evernorth, which is hired by major American insurance companies and provides coverage to 100 million consumers — about 1 in 3 insured people. EviCore by Evernorth is owned by the insurance giant Cigna.

Dialing for Dollars: America’s largest insurers hire EviCore to make decisions on whether to pay for care for more than 100 million people.

“The Dial”: EviCore uses an algorithm that allows it to adjust the chances that company doctors will screen prior authorization requests, increasing the possibility of denials.

Lucrative Deals: Some EviCore contracts are based on how deeply the company can reduce spending on medical procedures. It tells insurers that it can provide a 3-to-1 return on investment.

https://archive.ph/cXPRQ



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