re: A Doctor at Cigna Said Her Bosses Pressured Her to Review Patients’ Cases Too Quickly.

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I agree with the posters here that say if it’s meets the criteria of a partnered doc, it should be covered.

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I do agree that fi something meets criteria it should be covered but thats not really what the article is describing. It's describing something that doesnt meet criteria.

If there is something that a medical director reviews because it already doesn't meet standard criteria (meaning the nurse who initially reviewed it flagged it for denial) that decision falls to them. Another medical director reviewing the same case could have a different opinion and approve it so for those cases that are denied, the patients do have appeal rights to have the request reviewed by third party review sources which are clinicians for another opinion.