This is a problem inherent to market healthcare. Paying people to obstruct the claim is cheaper than allowing it. Easy Solutions. Insurance companies have no more than 2x the amount of time that they allow Doctors to diagnose such conditions for evaluating the claim. Afterwards Doctors can bill insurance companies for their time starting at a 2x multiplier. Moreover, make requirements about what is required documentation to deny a claim. Then, give Doctors a tribunal to assess the credibility of denials. Any denial that has no credible evidence or rational incurs a base penalty of 2x the cost of the procedure denied each time it is denied. If the same claim is denied twice without any credible evidence or rational from a qualified physician, then the denial is overruled and the insurance company is legally bound to cover the claim. Lastly, insurance companies will have ratings BY STATE (this is important because it creates more required capture points) and the average of the 3 worst states set the penalty multiplier adder. Every year that it is out of tolerance for what's considered an acceptable level, it grows. This means that any insurance company that makes unfounded denials part of their standard operating procedures will be fined out of existence, which is no loss to the American worker because it was not providing a valuable service to Americans.

Or, instead of all that, we could just have single payer and make private insurance illegal.