Your initial framing and argument made it seem otherwise.

Understandable because I said she works for an insurance company. But it was not my intent. No need to apologize for this.

It is natural to assume that you did not believe the same standard applied to reviewing doctors at Medicare since you’ve been arguing the same.

I disagree that it’s natural. I said doctors, not just doctors providing care (which my wife is still one of, btw). I suspect that this is an issue of viewing it as too black and white … so because I said one “side” is not perfect…well I must then think the other “side” is perfect.

I see no evidence that these denials are saving more money than is being wasted fighting them.

This is a different question than the one I’m trying to answer. I haven’t seen the books or analysis, so I don’t know whether it is more efficient. However, just peripherally, even i can see how much waste there is an even as a laymen it’s easy for me to understand that so many of the things she sees are just blatantly not medically necessary.

Doctors are notoriously bad at documentation.

Times they are a changing. Them not justifying why they are doing something is no longer adequate, and wont be adequate even if (maybe even especially if) we move to universal health care.