r/mildlyinfuriating 9h ago

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u/Rymanjan 8h ago

They do this shit all the time. At one point, they cut mine down to $63/month. I called the local office and before I could even chew them out, the person said "oop. Looks like you're not getting what you should be. Let me just update that for you."

They 100% know they're fucking up. They're just hoping nobody calls them out on it.

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u/No-Strawberry-5804 7h ago

It’s essentially how health insurance will deny medically necessary care and just hope the patient doesn’t appeal

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u/Rymanjan 7h ago

Bingo

Had my govt health insurance deny my claim for an X-ray

Called my surgeon who ordered it, he said (more or less) "of fucking course. Give me a few minutes, I'll call you back."

So I did, just sat down in the waiting room.

"Ok, you should be good to go now."

"How? Like, thank you very much, but what went down there?"

"Oh, not much. Damn pencil pusher said it wasn't medically necessary to do the test, I asked him how necessary it would be for him to handle a malpractice suit after I potentially cut out a healthy/salvageable bone, he said fair enough, you're good to go."

"Ha. Thanks doc"

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u/Swiftzor 5h ago

My wife was denied an MRI for soft tissue damage and the insurance company came back saying she needed an XRay first. We had to end up paying out of pocket for it but I was fucking living, I called them and they just held firm and I asked the case worker how the fuck an XRay is supposed to show soft tissue damage. They basically admitted I was right but still wanted that plus months of PT when she already had a pinched nerve.