Incident 591: Cigna Algorithm PXDX Allegedly Rejected Thousands of Patient Claims En Masse in Breach of California Law
Description: Cigna health insurer faces a class-action lawsuit for allegedly using the PXDX ("procedure-to-diagnosis") algorithm to automatically reject over 300,000 patient claims in violation of California law, prompting two members to file the lawsuit seeking damages and a jury trial. Cigna disputes the allegations, claiming the process expedites physician reimbursement and does not result in care denials.
Entities
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Incident ID
591
Report Count
2
Incident Date
2023-07-24
Editors
Daniel Atherton
Incident Reports
Reports Timeline
forbes.com · 2023
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Cigna, the healthcare and insurance giant, was hit with a lawsuit on Monday that alleges the company systematically rejects claims in a matter of seconds, thanks to an algorithmic system put in place to help automate the process—further rai…
apnews.com · 2023
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SACRAMENTO, Calif. (AP) — A federal lawsuit alleges that health insurance giant Cigna used a computer algorithm to automatically reject hundreds of thousands of patient claims without examining them individually as required by California la…
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