[lotsofpulp]

That’s a naive statement.

> Do you think a health insurance company pays claims?

Yes, see exhibit 2:

https://www.oliverwyman.com/our-expertise/insights/2025/may/...

> At least when you work for a corporation you don't have to see the truly ugly side of health insurance claim denial.

I cannot tell if I am being trolled. The only logical conclusion to this statement is you think “corporations” instruct the managed care organizations they pay to pay all claims. To which…lol.

[circumcised]

A health insurance company can easily manipulate claim stats by paying claims to doctors/healthcare companies owned/operated by the health insurance company. Essentially moving money from one subsidiary to another.

First-principles. ____

A Fortune 500 company has teams of lawyers, HR departments to ensure that a basic cholesterol blood test doesn't need to be approved or fought to be covered. When you are no longer "protected" by the corporation you are fighting on your own.

It doesn't seem like you have any real world experience dealing with health insurance companies.

[lotsofpulp]

> A health insurance company can easily manipulate claim stats by paying claims to doctors/healthcare companies owned/operated by the health insurance company. Essentially moving money from one subsidiary to another.

No, they can’t. They don’t even own hospitals, where a good portion of the spending happens. Nor do they own the medicines that are the highest profit margin item in the whole healthcare chain.

> It doesn't seem like you have any real world experience dealing with health insurance companies.

You would be wrong, but to avoid appeal to authority, you can explain why the managed care organizations are terrible investments if they deny claims willy nilly. It is one of the wonders of the modern world, all 7 publicly listed managed care organizations are simultaneously pilfering their customers and their shareholders. And they have the same insurance prices as the non profit insurers, who all have to get their prices approved by 50 different state insurance regulators.

https://totalrealreturns.com/s/CVS,ELV,UNH,MOH,VOO,CNC,HUM,C...

If the health insurance executives can pull off that kind of coordination to achieve that kind of theft, they deserve it.

> A Fortune 500 company has teams of lawyers, HR departments to ensure that a basic cholesterol blood test doesn't need to be approved or fought to be covered. When you are no longer "protected" by the corporation you are fighting on your own.

A fortune 500 company is likely self insuring. The managed care organizations wouldn’t even be affected by approving or denying the claims, the employer is the one paying. Smaller businesses are buying the same ACA compliant insurance as an individual would from healthcare.gov.

[circumcised]

Take United Healthcare for example. They own...

Optum Health: Delivers care directly to patients via local medical groups, urgent care centers, and surgical facilities. Optum Care: A major component of Optum Health, this network employs or partners with physicians across the country to provide value-based care. Optum Rx: Pharmacy care services. International: Owns and operates healthcare facilities in South America and Europe.

It's not difficult to see how a Health Insurance company with 4,000 subsidiaries could easily move money around and manipulate claim stats.