Denied

An American Healthcare Thriller

von Robert Ligon

404 Seiten, Hardcover

Kurzbeschreibung des Verlags

TWO MILLIMETERS SHORT OF CARE.Margaret Osei, a retired schoolteacher from Evanston, has an aneurysm in the main artery of her chest. It measures 5.8 centimeters. Medical guidelines call for repair at 5.5. Her insurer will not approve the surgery until it reaches 6.0.The graft is on the shelf. The operating room is on the schedule. Her surgeon, Dr. Ethan Calder, has been on hold with the insurer for forty-seven minutes. The answer, when it finally comes, is not no. It is ten to fifteen business days.The aneurysm does not observe business days. Every week of waiting stretches the artery wall thinner. If it tears before she reaches the operating room, a ninety-minute repair becomes a fight against catastrophic internal bleeding.Calder has watched a denial run out the clock before. Six years ago, Tommy Reyes, thirty-four and the father of two daughters, waited through round after round of authorization while a blocked artery starved his tissue. By the time Calder got him into surgery, it was too late. Tommy died the next morning. Calder has kept a record ever since, and at the bottom of it he has written three words: delay is the product.In a data center outside Baltimore, a data auditor discovers why. Hidden inside a platform licensed to insurers covering 170 million Americans is a set of algorithms built to predict which treatments can be denied or delayed. He sends the evidence to Dr. Sarah Nadir, a federal systems scientist who has spent years fighting prior-authorization delays. Within hours, his car is pulled from the Patapsco River.Now Sarah, Calder, an ex-NSA operator, and a nurse whose binders hold the names of hundreds of patients the system made wait must turn that evidence into something that cannot be denied, before the people who built the machine decide how far they are willing to go to protect it.Every week they lose, Margaret Osei's aneurysm grows. And she is not the only patient on the clock.DENIED is a gripping medical thriller about artificial intelligence, corporate power, and the invisible decisions that determine who receives treatment and who is left to wait.Drawing on more than four decades of firsthand experience in healthcare, biotechnology, and revenue-cycle technology, R. W. Ligon takes readers inside a world rarely explored in fiction: the vast administrative machinery that stands between a doctor's order and a patient's treatment.For readers who enjoy the legal intrigue of John Grisham and the technological suspense of Michael Crichton, DENIED asks a chillingly plausible question: What happens when the system built to manage healthcare decides that waiting is cheaper than treating you?

• Themen: Medizin Medizin / Gesundheitswesen, allgemein Medizinische Informatik
• ISBN: 9798993358338
• Sprache: Englisch
• Erscheinungsdatum: 29.09.2026
• Größe: 229 x 152 mm
• Verlag: Rwligon