An X post of one Dr Zachary Levy has gone viral as the doctor claimed that one of his patients was denied the medical insurance claim by UnitedHealthcare. The patient is in ICU with a brain hemorrhage, in a coma, on a ventilator and in heart failure, the doctor said.
“…because I haven’t proven to them that caring for her in the hospital was “medically necessary”. Tear it all down,” the doctor wrote.
The post comes as UnitedHealthcare is the target of public outrage because of its high denial of claims. Its 50-year-old CEO Brian Thompson was killed on December 4 in New York by accused Luigi Mangione, who was hailed as a hero by the disgruntled customers of the insurance company. 26-year-old Luigi Mangione was never a customer of UnitedHealthcare but he chose Thompson as his company deemed fit for his target. Mangione’s target was insurance — though he pleaded not guilty to the murder charge.
Dr Zachary also posted the letter that he submitted to the company explaining the medical necessity of his patient.
“I am writing on behalf of my patient, XXX, to document the medical necessity of being on a ventilator in the intensive care unit for the treatment of their brain hemorrhage, cerebral edema, and respiratory failure. Their treatment was medically necessary to prevent them from dying during this visit,” the letter said.
As the port went viral, many users reacted with their experience with UHC. “While I was going through stage 3 cervical cancer in 2016 I was denied by @UHC. The reason? They said the result of my diagnosis was due to an accident. I called in and asked how I could have accidentally caught cancer? The agent explained that they had a third party company that did their initial reviews that deny everything on their first review and apologized for the mistake,” one user said.
‘Insurance companies only pay for treatment’
Many users also took the side of the UHC on this specific incident that the doctor cited and said that insurance companies only pay for treatment. Another said that the incident probably did not even happen and even if it happened, it was probably a bureaucratic error but this should not have kept the patient from getting the care they needed, one said.
“I know it’s not the doctors arena really, but if prices at hospitals weren’t so outrageous, maybe more claims would get approved. System is broken on so many levels,” one wrote.
Recently, an ex-employee of UnitedHealthcare claimed that they were trained on various ways to deny claims while there was no training to clear claims.
UnitedHealthcare earlier said it approves and pays about 90 per cent of medical claims upon submission and social media claims about denials were highly inaccurate and grossly misleading. The company was previously involved in a lawsuit in which it was accused of using an AI toll that led to a 90 per cent error rate.
