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kicking feet rule (lemmy.blahaj.zone)
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[-] beefbot@lemmy.blahaj.zone 40 points 1 week ago

No probably he’s still grieving for his loved one who died as a direct result of their medical care claim getting denied (& 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)

And if he’s really smart he’d stay offline entirely for a long while

But I bet he knows, without that modern psychosis (having to constantly know what people say about you online), what a difference he made 🙏

[-] medgremlin@midwest.social 16 points 1 week ago

(& 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.

[-] beefbot@lemmy.blahaj.zone 2 points 1 week ago

Gods. Gods. I’m so sorry this has happened to you & I wish any words could do anything but: I read this, lots of strangers here did, & you telling your story made a fucking difference. I hope everyone in this situation gets what they deserve, & most of all you who deserves healing and health and care

[-] medgremlin@midwest.social 2 points 1 week ago

I just want to clarify that these stories are about patients I have cared for. I have had my own personal fights with insurance regarding coverage for life-preserving medications and diagnostic testing for damage caused by incorrect medications that I used to be on, but what I discussed here are other people whose medical care I was involved in.

[-] NotAnonymousAtAll@feddit.org 11 points 1 week ago

probably he’s still grieving for his loved one who died as a direct result of their medical care claim getting denied

Another scenario that seems likely to me is that he's only got a few weeks or maybe months left to live himself due to a denied claim.

[-] needanke@feddit.org 2 points 1 week ago

Apperently he was his loved one (was denied treatment himself)

this post was submitted on 08 Dec 2024
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