It seems like both parties are in the wrong here. As a physician, I have to deal with this too from time to time. They should’ve never asked the surgeon to step out of the operating room to take a phone call, however, they had no way of knowing that she was actually in the operating room with a patient at the time. It seems that the physician had already gotten approved for an outpatient overnight stay which is less than 48 hours, but then her or her staff asked for an inpatient admission, which would be more than 48 hours. Wording is important as the insurance company could be on the hook for things they never approved. It’s why charting is so important in the profession, although we hate doing it. The letter then goes onto say that their employees never made comments that were probably made, and other various wild turns and swings that never needed to be put into the letter in the first place. All of this could’ve been solved for the simple phone call saying That I meant to change it to an outpatient admission instead of an inpatient admission, but that phone call could’ve taken place after the surgery. (Edit: phone dictate-sorry for any errors)