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Cigna doctors spend an average of 1.2 seconds per case. Their whole system is to deny everything right off the bat, and then they only have to potentially pay out for patients who have the resources to appeal.
When I was in the insurance industry, for a company who administered various policies from Aetna, BCBS, Cigna, United and Medicare, that was the SOP. Deny anything that took more than a few seconds of brain power, put clients through endless rounds of appeals. The medical director was amoral AF too, because well, the insurance company exists for profit, and bonuses are dependent on paying out as little as possible. It got pretty bad, too, enough that my immediate supervisor started signing off a bunch of approvals, circumventing the medical director, where any shred of plausibility was available.
Now, there is automated software. HIPAA has it's pros and cons.
Oh, I read this John Grisham book.