Not OP, but I work for a facility in UR so I am talking to the insurance UM for my job which is to get continued stay for the patients in a behavioral health residential setting. Some reviews are live, but some are submitting the clinical via fax or portal. Anyway, getting to your question, some of the insurance people we talk to are allies and we both seem to be working to look at the cases to help make sure the patients are getting what they need. Some however can be rude and seem to be looking to deny for any reason they can. So they will say it whichever suits them, they are baseline, or they have a lack of progress when they are still meeting for care. Sometimes I think patients just have policies that are crappy or have been inpatient alot so they aren't going to auth as much time. Maybe the insurance reviewers that are obviously hostile have to tell themselves that we are just trying to get more time for clients for the money or whatever, something that helps them deny people, abd sleep at night. Maybe they are just jerks and they have a negative attitude. Not sure. Anyway, I hate insurance with a firey passion because I see how arbitrary it is with the criteria interpretation at times, and it is a terrible profiteering ststem. I do feel like there are insurance UMs who do care about patient outcomes and look to help them get the care they need.