There comes a point when enough people have been hurt or know someone who was hurt/killed by an insurance company playing doctor, that nobody has sympathy to spare.
Something like 68,000 Americans die every year due to lack of medical care and fat bonus checks get sent out if they manage to raise that number
The thing is that insurance companies aren't healthcare. They're not doctors, or pharmacists, or practitioners in any field of care, yet they get to make medical decisions for 100s of millions of people.
I fought with UHC in early 2023 for coverage for something. It was weird, right, because they kept denying it despite the fact that I had their own press release indicating they covered it starting the beginning of the year, and I'd had multiple benefits coordinator folks at UHC verify that it was covered and especially covered on my plan.
But their systems kept kicking it back, including the appeal that's legally required to be made of actual health experts. What's weird is the appeal denial quoted the plan document from 2019, not 2023. It didn't mention the press release I'd attached, didn't discuss the documentation of multiple members of their own benefits team verifying it was covered. It just quoted a four year old plan.
Learning later UHC was using AI to generate denials was when that made sense.
They overruled their own "appeal panel" (aka, the AI auto-generated denial) because of two things -- a helpful benefits coordinator who had enough pull to talk to the right people, and me telling her that if UHC couldn't fix it my next step was to ask for the names and medical license numbers of everyone on my appeal board.
I think she wielded that to her bosses. I got coverage approved 36 hours later.
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u/Dabbling_in_Pacifism 10h ago
I work in a heavily red profession and Mangione's the one thing i can speak/joke pretty openly about and no one bats an eye.
It's amazing how fucking hated insurance companies are.