I know people will default to believing the physician and not the lawyers, but from my read of the letter it appears UHC’s lawyers have valid points (don’t shoot me, I’m just the messenger)
Specifically, UHC appears to have recordings of the calls and the paperwork which contradict the claims in the social media post.
The two biggest problems I see from my quick read:
1. UHC’s rep said the issue was non urgent and asked for a call back “when convenient to you”. This differs from the social media post claiming that UHC called and demanded she “scrub out of surgery” and “call right now”.
2. UHC has records of the doctor conceding that her office’s submission for inpatient care was erroneous and that they actually meant to request observation care. That’s why UHC was calling.
The fact that UHC came with receipts (recordings of the phone calls) and that the doctor even conceded the error during the call does not put the doctor in a good position. The original claim that the insurance rep demanded she scrub out of surgery immediately was a red flag that something was amiss with the story.