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4 Month Old Baby Gets Rejected for Pre-Existing Condition With Health Insurance – Obesity at 17# – Case of Bad Algorithms

Posted Oct 12 2009 10:01pm

I keep stating that the algorithms run by health insurance companies need to be certified just like EMR algorithms for medical records, so here’s a image perfect example of algorithms gone wrong.   How can a health baby just a few months into the world be severely “scored” like this?  The insurer has since stated they would adjust their underwriting procedures (algorithms) to allow the baby and others like this to be covered, oh those algos up to it again!

“Department of algorithms – do we need one of these to regulate ...

Interesting when you watch the video they reference “the system”, and the “system” is the “algorithms.”   Again, if you learn nothing else at this blog than the meaning of that word, the computer formulas used against those who are ignorant, you are miles ahead. 

Is algorithmic fraud becoming a business model for healthcare?   Somebody had to do the programming here, so who did it?  It’ not a system that does it on it’s own, someone has to give approval to run them in their present format, so again with all the discrepancies' we see and bad billing, why not certify the insurers algorithms so we don’t have more cases like this one.  BD

DENVER - A Colorado insurance company is changing its attitude about fat babies.

Rocky Mountain Health Plans said Monday it will no longer consider obesity a "pre-existing condition" barring coverage for hefty infants. The change comes after the insurer turned down a Grand Junction 4-month-old who weighs about 17 pounds. The insurer deemed Alex Lange obese and said the infant didn't qualify for coverage.

Fat baby can get coverage after all, insurer says - Kids and parenting- msnbc.com

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