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Post being replied to
I've told our United Healthcare story here before... by Kbyrnes
...To briefly reiterate one example, a local Chicago-area university-health-center-based orthognathic surgeon who personally examined a subject determined the medical necessity of a procedure. UHC had an ENT in Baton Rouge look at no scans, but just the request, and "determine" that it was just an overbite (or an underbite, as it was then called in the next sentence) and did not require the procedure.
If I'd been a meanie, I'd have filed a complaint against this goofy ENT's medical license. It's evident that there are medical professionals out there who are just rejection machines who are paid a piece rate.