• Catoblepas@lemmy.blahaj.zone
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    4 days ago

    It’s not nitpicking, it was the literal denial reason. You are explaining why you think it was okay for them to do, but that’s not the reason given for a denial. They need to be able to defend what their denial actually says, not what you think it means, in the event of a lawsuit or appeal.

    “Medically necessary” has a legal meaning, and it’s not dependent on whether you consider them a ‘useless eater.’

    • Imgonnatrythis@sh.itjust.works
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      4 days ago

      Medically unnecessary = we don’t support the decision making and don’t want to pay for it. It’s the only language they will ever use. This is just the wording insurance companies use to deny claims.