196

(& I promise you Chipmunk Cheek’s rich sociopath family is looking at every record in their business to find out who they ficked over so bad)

Having fought with UHC to get curative cancer surgeries approved, I promise you, that list is so long as to be basically useless. They're looking for a single fish in the Pacific Ocean here, and it's their own fucking fault. (I have literally had them approve the excision of a malignant melanoma, but require prior authorization for the 10cm diameter skin graft to repair the area excised because the procedure code technically falls under the plastic surgery heading.

They don't even look at what the procedure is or what it's for. All procedures and billing codes fall under various headings and more than half of them fall under headings that require prior authorization with a massive pile of documentation and justification attached.

I've also had them get pissy about things like medically necessary panniculectomies (removal of the skin/fat apron at the bottom of the abdomen) for someone that lost about 200lbs and was getting literal necrosis of the skin in the fold because of the irritation and friction from the pannus. Like, yes, I know that sometimes panniculectomies can be borderline-cosmetic, but this poor lady had over a foot of overhang after her diligent weight loss from diet and exercise and she had already had one hospitalization for sepsis from the severity of the skin infection from the skin breakdown. I had to submit those hospitalization records and 3 sets of photographs of the skin breakdown from 3 separate appointments to prove that it was a consistent problem.

If you can't tell, I am very angry about how insurance authorization works and I have intimate knowledge of the process. It drives me absolutely mad that people with MD, DO, or international medical degrees with no knowledge or expertise in the specialty at hand are the ones that review the appeals for the automatic denials. UHC was by far the worst offender and they deserve everything coming their way.