It's absolutely intentionally malicious, despite the individual employees not having much say... have you ever tried to bounce between calls to get information for an insurer from a hospital billing department? they can make vogons look efficient

I've spent hours trying to get an estimate for a inpatient surgery only to find out afterwards that the surgeon used a different billing code than the billing department gave me

then the insurance company won't cover it because it's not the billing code they cover, and the hospital won't change the billing code