Hey, more fine work by our "peers" doing reviews. Anyone doing this kind of garbage work should be ashamed of themselves. Really, how can you look at yourself in the mirror??
Aetna has settled a lawsuit in which a company medical director said under oath that he never looked at patients' records when deciding whether to approve or deny coverage -- testimony that prompted an investigation by the California insurance commissioner.
www.cnn.com
"How would you decide on your own when to actually review the medical records versus relying on what the nurse at Aetna had prepared for you?" Glovsky said.
"What percentage?" Iinuma asked.
Glovsky: "I mean, like, did you ever look at medical records or basically whenever --"
Iinuma: "No, I did not."
Glovsky: "OK. So as part of your custom and practice in making decisions, you would rely on what the nurse had prepared for you?"
Iinuma: "Correct."
Glovsky: "Instead of actually looking at yourself the medical records?"
Iinuma: "Correct."
Glovsky: "And was that throughout your -- your years at Aetna?"
Iinuma: "My tenure, yes."
Glovsky: "Was that how you were trained to do it when you joined -- first joined Aetna?"
Iinuma: "To my recollection, yes."
www.kevinmd.com
