misterman
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Oddly enough, I see nothing in there about denying claims or expending massive resources to figure out how to do so.
Heck, they use software to try to find any lame excuse they can to deny:
The problem is bound to grow as insurers make use of sophisticated data tools dubbed "denial engines," which are touted to reduce reimbursements by 3 to 10 percent. Bearing brand names like Ingenix Detection Software and Bloodhound Technologies' ClaimsGuard, they search patient records for any signs that claims have strayed outside company parameters. Weeding out fraud or speeding up processing is one thing; serving up excuses to deny legitimate coverage is another.
How Crafty Health Insurers Are Denying Care - US News and World Report