June 13, 2024 at 5:49 am

An Insurance Employee Was Tasked To Deny Medical Insurance Claims, But When They Couldn’t Take It Anymore They Just Approved All The Cases

by Heide Lazaro

Source: Reddit/MaliciousCompliance/Canva

Insurance companies often present themselves as benefactors. But behind the scenes, they implement practices that are often questionable.

The following story concerns a former employee who shared their firsthand experience of doing something that just didn’t feel right.

Let’s take a look…

Stop slacking off and get to those insurance denials? Sure thing boss

This happened a few years ago, but was reminded of it because a lot of it is becoming public.

Insurance companies are not your friends, and will do everything they can do to save money, including not paying for your medically necessary services.

There’s a lot of news coming out about insurance companies using algorithms to deny claims, and doctors signing off on them.

This was OP’s role before the tools and algorithms.

Before algorithms, they would have minimum wage employees reading over these claims for the doctors instead.

That’s what I was. I was 19 years old, working for a insurance companies denying claims.

I would be the first line for doctors to call and give their case for why they thought they needed a service or medicine.

For some reason, 19-year-old me with no medical experience was allowed to tell these doctors that services were not needed medically.

OP never liked what she was doing for the company.

This job was the easiest, yet most miserable job experience I ever had. I was only able to last a few months there.

During my last 2 weeks, I was really slacking off. I was just so burned out.

I couldn’t stand denying yet ANOTHER case where someone needed meds, and the insurance company didn’t want to pay for them.

I was reprimanded for not working hard enough and getting processed.

OP sure had a plan and didn’t think twice of executing it.

Insert malicious compliance.

I worked faster than I ever had before. That’s because I approved every case that came before.

Every doctor I spoke to, I just gave them approval. Every prior authorization I saw was approved.

Such a noble act to do.

During my first week, I did this once and was told to not do it again because I have to follow company guidelines, but I didn’t care at this point.

I probably was able to approve 50+ cases before I quit. I hope it made it difference to those people.

**** health insurance companies.

Let’s check out how other Reddit users react to this story.

Here’s an appreciation comment for OP.

Source: Reddit/MaliciousCompliance

This user expresses their confusion.

Source: Reddit/MaliciousCompliance

While this one shows frustration with insurance companies.

Source: Reddit/MaliciousCompliance

It can’t be any truer than this!

Source: Reddit/MaliciousCompliance

This short comment says a lot.

Source: Reddit/MaliciousCompliance

Small good deeds can make huge impacts.

Good job!

If you liked that post, check out this one about an employee that got revenge on HR when they refused to reimburse his travel.