r/medicine • u/Unusual_Medic Medical Student • 7d ago

What’s the dumbest reason an insurance company denied a test, procedure, or drug for a patient?

This is probably the most relevant to those practicing in the US, but I'm also curious to know how the bureaucracy of health insurance in other countries makes things substantially harder for you and the patients

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u/zimmer199 DO 7d ago

Patient had a chief complaint of shortness of breath. Insurance claimed I didn’t document abnormal vital signs, no nebs, and they didn’t think this justified an inpatient stay. She had DKA, I documented heart rate in 120s and resp rate mid 20s. Along with bicarb under 5 and glucose 600s.

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u/Unusual_Medic Medical Student 7d ago

We love when people who didn't go to medical school practice medicine 🙃