It gets worse, and on both sides of the coin. I was a paramedic (and before, an EMT) who has responded literally thousands of times to SNFs (skilled nursing fa

It gets worse, and on both sides of the coin. I was a paramedic (and before, an EMT) who has responded literally thousands of times to SNFs (skilled nursing facilities). Dozens, if not hundreds of these calls were for the most trivial of concerns. A nurse told us at one facility that their policy was "anything larger than a bandaid, call 911", so we'd do "first aid" while two nurses stood by and watched us. I'm sure they (the facility) had motivations on liability, etc., but nonetheless, it was utterly galling that you'd leave such a facility and see big proud billboards or ads offering "24/7 nursing care!" - and knowing that they were certainly charging the patient or their family for a rate commensurate with that, potentially five digits a month, while offloading all their work to 911 and relying on skeleton crews of an LPN per floor supervising way too many CNAs. They'd also routinely "forget" to fill out paperwork on ambulance necessity (Medicare, and many insurers, have paperwork to justify why the patient was not suitable for private vehicle or wheelchair van transport and instead needed a "fully equipped BLS/ALS ambulance"). It wasn't onerous, a single pager with a bunch of checkboxes, "Does the patient pose a fall risk?" "Need for oxygen?" "Unable to support themselves in a sitting position", etc. But we'd have to fight tooth and nail to get anything more than "patient name, DOB, and an illegible provider signature". Insurance would routinely reject payment, etc. UHG involved in more of these shenanigans? Not surprised. They were slapped several years ago for denying HEMS (Heli EMS, aka "Life Flight") from severe MVA / trauma scenes due to lack of pre-authorization... ("This is John, I'm a paramedic working on one of your patients who was hit by a truck. We would like to fly him to the hospital due to his extensive multisystem trauma but we need your authorization. His name? Hang on, let me find his wallet. No, that's Smythe, S-M-Y-T-H-E, sorry, I know, it's a bit loud with the jaws of life in the background... Uhh, sure, I guess I can hold for a nurse consultation...")