Some on reddit.com/r/anesthesiology say it’s fake. Others say this is not for doctors but for the patient.
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Let’s just suppose for a second that this really was unnecessary. is it the patient’s fault or the doctor’s? Truly the most insane thing in all of this is this expectation that the patient should be on the hook for unnecessary medical expenses when they quite literally are the least informed of all the parties in the situation.
That reads like someone ticking boxes in some software, assembling a reasoning from pre-written sentences in “simple English”. Do they use that kind of tools?
It’s nice of them if they do it like that. That way the reasoning is better exposed. The reasoning is easier to evaluate. It is easier to spot the point where the reasoning breaks down.
Would you rather that some bloke makes a vibes based decision where it breaks down to skin colour or perhaps just how they are feeling that day?
What?
While I don’t disagree that this happens frequently, the wording seems to be unrealistic. They would never go into this much detail, in such an unprofessional way. They have form letters that get vetted by legal teams. This would never pass.
Of course I could be wrong and this seriously is how UH talks.
It’s been several years, but I’ve received something similar from UHC, maybe only a few sentences shorter. This reads to me like the same bs put through an LLM.
I did get them to cover their denied service, btw, after faxing over the world’s thinnest-disguised pissy letter of contest to their decision. I’m not an easy person to anger but let me tell you, I saw red when I got that denial.
Well, you know what to do next time.
See, I immediately thought oh it might be fake but then people in the comments pointed out that they have gotten letters exactly like this.
The unrealistic thing about this is the time frame. For a stay that happened at the end of November, to have a reply in hand two weeks later is unreal.
With UHC, this is not unrealistic in the slightest.
I had a follow-up appointment with a specialist I’ve been seeing last Friday. My lab results didn’t show the progress we were expecting, so we decided to attack the issue with a particular medication. This medication is injectable, not a pill like the ones I’ve been taking that have proven to be ineffective, and it’s sold under three names; we discussed all three, and before I left the office, he submitted the prior authorization request.
Given that I’m insured by UHC, the prior authorization was denied. Not only was it denied, they robo-called me to say so, sent a letter via mail, and put a copy of the letter in PDF form on my account, before I got home from the doctor’s office.
Not only that, but the section of the letter where they’re supposed to recommend alternate drugs was blank. So basically, “we’re not going to cover that, you can keep suffering, go fuck yourself” in less than 15 minutes.
UHC is exceedingly efficient at not giving a shit.
Wow that sucks. When the first discussions of Obamacare came up, Republicans should have went with “we don’t need govt death panels, we have death panels at home!”
Yeah that’s a good point. I get shit months after.
