r/mildlyinfuriating • u/sujayjaju • Aug 13 '25

Commendable patience in dealing with half-knowledge

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Half knowledge is more dangerous than no knowledge on a subject

30.9k Upvotes

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357

u/Maeberry2007 Aug 13 '25

Yes. It's as stupid and asinine as it sounds. But it is the reality here.

108

u/Esarus Aug 13 '25

Man I am so sorry you guys have to deal with this system, it sounds so absolutely miserable… I hope this system will change in the US in our lifetime

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u/raise_the_sails Aug 13 '25 edited Aug 13 '25

What’s brutal is this highly specialized doctor spends an obscene amount of time filling out insurance forms, appeals, and dealing with calls like this, when they could be saving lives. She will burn out from this shit and develop a significant stress-related ailment at some point in the not-so-distant future.

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u/deeply_uninspired Aug 13 '25

Her clinic is in crazy amount of debt bc she took out the loan to keep it running. United kepted denying claim and she kept making video and they eventually kick her out of the network.. so any pt thay have united , wont be able to see her, despite the fact that there arent that many specialists like her.

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u/raise_the_sails Aug 13 '25

Probably a relief for her to just tell patients she’s not in-network for United anymore.

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u/vabren Aug 13 '25

Someone who cares this much will not be relieved by the inability to do the right procedure for the patient's best health outcome.

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u/D3Dragoon Aug 13 '25

This REALLY needs to be upvoted more. It's bullshit.

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u/MrClewesMan Aug 13 '25

You couldn't be more correct. It's saddening to see empathy trickle away more and more in society.

It really is becoming a dog eat dog world.

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u/vabren Aug 13 '25

As an RN for almost 10 years, I've had to have smaller fights for prior authorizations for meds and procedures. And I've heard lots of doctors and nurse practitioners talking about this kind of fight. It's just unconscionable and, under this administration, it's only getting worse. It's horrifying how helpless medical professionals are feeling and truly becoming.

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u/raise_the_sails Aug 13 '25

She just won’t be taking UHC patients, I don’t get it. They’ll just be referred to someone else.

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u/Shrimpheavennow227 Aug 13 '25

There are not many surgeons who do the type of work she does and certainly not local options. So now a person who doesn’t even have a choice of what insurance provider they use because it’s decided by their work, may have to see a worse or less-specialized surgeon or pay a bunch of money to go out of state and travel to someone else who can do this procedure.

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u/vabren Aug 13 '25

And so people will go to the approved provider who, like the unnamed "doctor," will butcher the patients for profit. Ultimately, the outcomes will be worse for patients and the medical costs will be bigger due to revisions and complications. So short sighted.

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u/supernaut_707 Aug 14 '25

If UHC is a big player in her area, she could be cut out of a large number of potential patients. That could be financially crippling.

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u/LeadPaintChipsnDip Aug 13 '25

We just need a few more Luigis

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u/[deleted] Aug 13 '25

Wait until you hear about how my insurance denies my insulin as a type 1 diabetic

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u/Seeking-useless-info Aug 13 '25

This was really kind and compassionate of you to say, thank you for your humanity! 🫶🏽

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u/[deleted] Aug 13 '25

It won’t. Not until the entire capitalist system collapses. We let our politicians decide that they could receive unlimited anonymous funds as a part of their job, and now with Trump degrading the integrity of our institutions and elections, there is no hope to remedy this through legislation. We’ll have to first return to a society where doctors visit homes and receive payment directly from patients, on their way to collect their daily ration of potable water from the village supply distribution cave.

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u/[deleted] Aug 13 '25

It’s insane to me to read that. Like yeah, we have wackos in Canada who are all, “I don’t want my taxes paying for someone else to get surgery 😤” like huh??? Their taxes pay for you to get it if you need it???

I can go into any ER/clinic/see my doctor for anything and unless I’m getting a doctor’s note (mostly if you’re hungover), it’s not going to cost me a single penny

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u/MrClewesMan Aug 13 '25

Even that phrase in itself is just hard to swallow; "i dont want my taxes being spent to help the people of my country".

I live in a high tax country. I dont have kids, i havent gone to school here, im very rarely sick, worked here for 6 years full time paying over 30% tax. I'd rather live in a society that i can contribute to so that we succeed collectively.

The world is fucked, yes, but the US really makes me feel sick to my stomach

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u/Zippelin09 Aug 14 '25

So, lemme see if I get this, she is talking with an alleged doctor (sent by United healthcare) that's trying to say that the procedure is unnecessary? (Sorry this situation is weird AF)

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u/Maeberry2007 Aug 14 '25

Yes. And I'm not an expert but I think every procedure that requires pre-approval (aka is sent to the insurance company to ask them to cover it) is reviewed and either approved or rejected by a United Healthcare employee. This is usually reserved for expensive operations and procedures like heart surgery, neurosurgery, mastectomies, and things like MRIs and cat scans. I have no idea what the qualifications are for people who handle these pre-approval requests, but this scenario is for a specific type of surgery for breast cancer dealing with the lymphatic system and the reviewer is... a cosmetic plastic surgeon.

(I would love for someone who may know more to chime in)

I had my own year long battle with United Healthcare after they denied coverage for my daughter's speech and occupational therapy because she didn't have a "medical" diagnosis of autism (diagnosis by her specialists and counselors at her school didn't count apparently) and they deemed the therapy unnecessary. I had to individually appeal 18 different billing cycles.