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Set up payment for March 2016 with credit card and United Health. Cancel the payment on 28th of February, 2016. Thus sending a computerized message to the Marketplace and my profile was cancel within Marketplace system as well! I regret signing up for United Healthcare. Now I have read the reviews on the company practices and lack of customer service. This is very poor representation of health care for United States! These are serious health issues and I experience waiting on the phone with a female representative giving me a male name (KEN) and placing me on hold for 40 minutes and did not return.
Before she placed me on hold, I asked her to repeat her name and she stated to me (KEN). So I repeated the name of (KEN) and spelled it out as I repeated the letters! She placed me on hold and never return. I ended up disconnecting the call and had to call back to speak to another representative. I have recorded the entire conversation with this representative (KEN) and if by any chance someone want to use this recording, please contact me so I can assist them with their matter!
I have had United Health Care since 2010. In 2012 I was let go from my job and went to cobra. In Sep 2014 I applied for individual coverage. I was approved, and it has been a nightmare ever since. They have closed my account at least 4 times, but don't bother to notify you for months and don't have a reason why. You spend days and weeks trying to understand why they somehow keep losing my payments, which are coming thru my bank, in an automatic bill payment.
For some reason, they can't find my checks. We have changed the date and the address now, but still they lose my checks, and tell my doctors I have been terminated, due to lack of payment. This seems to happen every time I go to the doctor. Last year they told me, outright, to go to another provider as they thought I could find individual coverage somewhere else less expensive. I pay close to 630.00 a month... Last yr they overcharged me and then wanted to credit my account for close to 700.00. It took months to receive my money back.
The stress and seriousness seems to not be an issue when you speak to a rep. Sometimes, they don't even have your file on their computer, or tell you, you have called the wrong 800 number, even though it is the one on their letterhead. How come the gov't allows this to go on? What can I do to file a complaint against them? I need assistance.
I have had United Health Care insurance since the beginning of 2015. I have always paid my health insurance payments, however, unfortunately, United Health Care never keeps their end by insuring me. All of 2015 I had to fight with them for every single visit. Each time I visited a doctor, the doctor was sent a letter to tell them I did not pay my premium and therefore the claim was denied. I had to escalate the issue and then they went back and credited my account. The blame game was going on... They said the marketplace (ObamaCare) did not send them over the payment I paid directly online. The marketplace said they did pay United Health Care premiums and they did not understand why it was not getting to my account properly. Luckily, I had not major issues with my health and so I ended up paying for insurance all year... But they just pocketed my money!
Going forward... 2016... was going to switch to Blue Cross, but my doctor was not covered under the plan so I was stuck with United Health Care as my only option. I decided to pay United Health Care directly each month for my premium payments. Well, March, I go to the doctor and have my mammo. Get letter and call that my health insurance was cancelled due to non payment again. They refused to pay the claim. 3 letters were sent out like this to my doctors as well as I was unable to get my prescription as they said I have no coverage, it had been cancelled.
I call United Health Care and... What do I learn??? Accidentally, Jan, Feb and Mar insurance payments were not posted to my account and the account was closed. As they researched, they found my payments but could not understand why it was not posting to my account. (I keep all of my confirmation codes when I pay now) and so they said they would start my plan over again. I had to re-enroll. They moved my payments over and said they would go ahead and pay the claims based on their error. They promised me it was all fixed. Went to doctor for annual physical, doctor informs me he is no longer my primary care so they will not pay insurance. He has been my primary for several years. Have to call again. Whoops they did not set him up on my account and assigned a random doctor when they re-enrolled me. Again, said it all fixed now and everything is working fine.April 24, 2016. Get a letter that was sent to my primary physician stating "we received a claim for... for healthcare services, the patient is not current with her premium payments. This is to notify that if we do not receive payment by member within grace period, the claim will be denied and policy will be terminated."
I called United Health Care again. Asked to escalate to a manager to make a complaint. Was told, "sorry you must write your complaint and send it in to us. Can't talk to anyone on the phone. By the way, we are showing your insurance has been paid, but just not posting correctly to your account." So tired of this company. Please if you have had similar experiences, complain, write letters, tell everyone. This has to stop. They simply don't care about you!!! I wish someone would investigate this company.
I read all the complaints. All are correct! Referral has caused me more problems, physical & mental. Phone calls are useless. You do hold while agent gets a super that never comes into reality. If you want to know the 4 month nightmare, be glad to share. As far as using their meds, they are not my doctor & have no right telling me the cheaper one of theirs to use is just as good. Please don't buy into UnitedHealth, AARP or any name associated... very sad for us seniors.
Long Story Short: United Health Care has lost 1B dollars on Obama Care in the past year. In order to keep revenue up they have put a CAP on what they will PAY for services. Hospitals and Doctors are not accepting their low ball offer for payment so your bill is not being paid or accepted. My wife cannot find a doctor to treat her Bipolar in the State of Ohio. No Doctor will accept UNITED HEALTH CARE so we are paying out of pocket. Simply put you may health insurance but you DON'T have health care. Contact your state representatives and file a complaint... PLEASE.
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I had a endoscopy done on Jan. 4th, 16 and due to consistent fever/inflammation for more than a couple of weeks. When called to the Customer care they told it is completely coverable by the insurance. I submitted for cashless claim and then said they need doctor prescription and couple of documents to approve, so requested to resubmit as reimbursement. Then after submitting they kept the claim on hold for couple months and after repeated follow-up, they closed the claim stating that it is an procedure and can't be claimed. Totally unethical!!!
My company switched to UHC from Coventry last year. I have received a letter in the mail every week from them trying to sell me on their home delivery prescription service. They're as bad as a credit card company. I tried to get my prescription transferred to a pharmacy closer to my work for convenience. They cancelled my Rx. The pharmacy said I had to call a 800 number and speak with my insurance about it. I was on hold for 30 minutes and had to verify with them that I indeed did not want their home delivery service. Now the pharmacy has to call my doctor and try to get the prescription renewed. And that's assuming that UHC doesn't block it again. It's a really good thing this is a mild Rx, and not something necessary for my life. I've been without medication for 3 days now, and I'm wondering how long this is going to go on. They're the worst.
Like many good ideas and institutions like Hospice, corporations ride on the good name. Such is the case of AARP and United Health. I quit being an AARP customer when I realized it was no longer fighting for my rights but the rights of United Health. Since AARP does not wish to do this, bye, bye AARP and UH.
I started with United Health Care on April 1. It's been an absolute nightmare. I was assigned a doctor after the first one canceled my appointment and then decided no longer to be with United Health Care. That put my appointment somewhere within the next two months because of this situation which was no doing of mine. Kept on telling them I need to see a doctor but they told me I was not eligible until May 1 even though it was their choosing to send me to a new doctor and their employee relationship with the old doctor was terminated. Told them I really needed to see a doctor because of nearly passing out. Emergency room doctor told me to see my primary care it was important.
But because of United Health Care lip service, I was told I couldn't and I was told I could and I was told I couldn't five calls later. One of the employees even told me that I needed to speak appropriately. I did not use any foul language, a bit irritated, but that maybe due to the fact that it's been two days and a lot of lip service without anything being ironed out. Today's hours on the phone and yes I mean hours. Something's finally been done so I've been told. Not quite buying it until I talk to my doctor, the one I've never gone to!
The problem is clear. They provide lots of lip service, lots of "yes ma'am we're doing our best" when it is apparently not what's going on. Bottom line: if my doctor can fix the problem, they make it go away and I would be safe to drive again. Don't you think it would cost them less than sending me to an emergency room?
If I were corporate I rethink this. They're not doing their investors any favors. They read a script. They don't understand the problem because they don't listen! I would change this if I got better treatment but so far like I said it's been an absolute nightmare. I'm telling everybody within earshot about my experience. I was literally put on hold for over 30 minutes at a time. My time is not valuable to this company, therefore, I am not. One really wonderful employee had taken care of this call the next day to set up an appointment and it wasn't in their systems. Nobody knew what I was talking about so you might think they would communicate but they don't.They literally wanted me to visit the emergency room every time I had a problem instead of taking care of the problem. By the way, that cost me $70 every time I make a visit. Question is if I were in an accident due to this condition and they had to spend much more money where is the savings in that? I'm a healthy individual according to the doctor at the emergency room. I have a great heart, kidneys, and liver! He felt it was probably something minor that can be
handled. I agree but not handled. It becomes a problem.
United Health Care is inefficient in every way possible at this moment in my life. I have a suggestion: if signing up for health care do not go with United, back away from the desk and run. These people do not treat you well. They are not concerned about your well-being. I have the horrible feeling that collecting your money is their first goal and seeing you in a pine box might be their second. I am not kidding. It was a scary experience!!!
I had a colonoscopy done 3/18/16 and it was to be covered at 100% as preventative; this includes anesthesia, and anything bill that had to do with this procedure. As of today, they have not paid everything and I am getting bills for this procedure. I have called United Health Care several times about this and was told they will resubmit the claim and they would call me back. They have not called back or taken care of this issue. It shows all claims processed when I log into my United Health Care account but they still have not paid these bills. The customer service is extremely bad.
Worst insurance company ever! I don't even understand how this company is still in business. Nothing but problems. They denied my claim even though they sent me prior authorization. When I asked what the authorization was for I was told it was to have the procedure. I do NOT need their permission to have a procedure done. That does not make any sense. Now they sent another denial but with the doctor billed under another name I have never even heard of. What a crock.
It is now the middle of April since my January appt and they will not pay my claim. I didn't have my cards or FSA because they didn't send them on time. So, I paid cash. I sent them a fully itemized invoice saying all that was done and that I paid up front. They harassed my doctor and myself and still haven't paid. I lost my temper in emailing them and they passive aggressively responded every time with something snarky like "hope you're having a great day" when I obviously was super frustrated and upset. The kicker now... they still haven't paid and are stating that they may bill me. TERRIBLE COMPANY. INCOMPETENT and DANGEROUS.
My mom recently passed away, and in going through all her paperwork, I discovered that she had United Health Care as her insurance. I wish she would have told me this because I would have warned her not to use this company due to their horrible reputation. Anyway, I phoned UHC to let them know my mom had passed away and asked them to please cancel her account. They informed me that before they'd do this, I needed to provide them a copy of her Death Certificate (which I could easily do), and that I also needed to provide proof that I was the Executor of her "estate". I told them that I could send them a copy of her attorney prepared, legally done and notarized will, which states that I am her only child and that I was indeed the executor of her "estate". I also told them that my mom had no "estate" to speak of, considering that she had lived in a small rental unit and had no car, but they didn't care about this.
The woman I was speaking to informed me that UHC would NOT accept a copy of the will, and that if I wanted to cancel her account and stop their billing, I'd need to go to court and get either a "Letter of Testamentary" or a "Letter of Administration". My husband and I don't have the money to see an attorney or to pay for one of these documents. Because of this, UHC won't even close her account! My mom is deceased, and yet UHC wants to keep her account OPEN! These people are unbelievable! I can't stand UHC and I've already warned everyone I know not to do business with them. If you're a senior and you use this unconscionable company, your heirs are going to have nothing but trouble when you pass away! Do them a huge favor and get different health insurance. I can't believe AARP even sponsors this company!
When my upper molar CROWN broke over a year ago my provider requested service approval. The affected surfaces are occlusal and mesial. There's a huge gap between the broken PFM crown and the adjacent tooth. I started getting food impaction, constant pain in the gum, frequent subgingival infections and inflammation. According to UHC customer service rep I have dental coverage. My provider's initial request for service was denied, an appeal was denied. Reason: insufficient evidence of decay. There's no tooth decay. It's a PFM! But the numbskulls in dental review department can't seem to understand by looking at clear pictures made by in intraoral camera my provider submitted.
I called UHC dental department and made an emergency appeal over the phone. Denied for the same reason. I asked for the name(s) and location of the incompetent responsible parties who denied treatment to file a complaint with their local board of dentistry, but UHC refused to provide that information. My only option is to go to a dangerous city where I would not go under any circumstances and appeal in some court or write a letter to some stupid clueless government entity, which will not resolve my problem.
At the same time another old implant crown broke. Same story - food impaction, losing gum and bone. According to UHC I have once in a lifetime benefit and the implant crown can be replaced. Provider requests treatment, UHC denies, reason unknown/not listed. Provider negotiated a very low fee $$$$$ with UHC and does not want to appeal.
I have chronic back pain. Until last year my primary doctor could request MRI. Not anymore. Now I need to get x-ray, then physical therapy. I had zero improvement after therapy, I refuse x-ray, it will not show anything. What's the point of having medical coverage if this business constantly denies procedures. Meanwhile I still get frequent gum infection, guzzle peridex, losing bone and will eventually lose my implants due to food impaction. I'm going to drop this idiotic United Somethingcare and don't want any coverage at all, thanks to their idiotic dentists that deny treatment. I do not recommend U B.S. C.
The insurance company play phone games. They are liars and time wasters. They continuously send me a card with a dr. that is not in network. They say it's the Dr office that needs to update and the Dr. Offices say it's the insurance co. I called to get a primary care dr.. again. Mine fell out of network in Nov! Meaning they haven't been paid by ins. Co for almost 2 years... so I was given many doctors that were supposedly verified and turns out no they don't take the ins, some for over 5 years now and not in same locations. A lot of times there is no such person at the office or at United Health Care because they lie and read that I'm sorry script. They do not give you a supervisor, they have fun doing these games.
Anyway, the insurance co with me on the phone called a dr and the girl said they take the ins. "And new patients, we welcome you..." she said. The insurance person just disappeared and I made my appt and gave my info to the office girl. A week later I called to see if I can get my husband with high blood pressure an appointment when I have mine. "Oh sure no problem and be sure to get the Dr. Name on card", that's all the doctor's offices care about that card and paperwork. Paperwork pertaining to insurance not your medical stuff of course. I called ins co. They said no problem but they are not in network so they can be updated by having them call the credential line or an online submission. So me as the patient have to get this done = again.
So doctor office was lost and confused and didn't know what to do so I actually gave her the credentials number that I got from UHC, which as a patient shouldn't even have! 2 days before the appt. Dr office twit calls and says "I didn't hear from insurance company so you can come in but it won't be covered." I told her "don't worry I spoke to a supervisor that handled it all, even the card are on the way." I called ins co, no Jessica as a supervisor even exists. I get different supportive supervisor that says Jessica said that dr and credentials are fine and "your all set cards are on the way too." They assured my appointments a go since I told them be sure because my husband and I are zipping there during his work day.
Well I got there and the cow behind the desk took my card and gave me info to fill out then was like, "o when did you make your appointment", so I told her "you know darn well it's been weeks and please don't do this circle talk to me again because by the way I am the patient and I actually been very very sick lately." She says really wise to who was standing next to her, in their cake clutch of 5, she's not gonna let me talk. I asked what she needs me to do now (for this part time job I gained), so she said "o well I didn't hear from insurance company and that's their job to update from here." So I wasted my time again. Called ins co. and they say there's no Jessica ** again and that doc hasn't been in network since last year because it's up to the Dr office to do that. Same story different day! No call back with a provider all day though they said they were calling back in an hour.
I call - they say a whole different doctor that 2 weeks ago wasn't in network, supposedly also... "that's the Dr on your cards assigned to you as of today." This is a bunch of circle jerks. They are getting paid to amuse themselves with these games instead of doing their jobs. They got paid for the aggravation, I just get more headaches. I don't feel any of the doctors even care how their office staff handles things. If they put down the cake and gossip and weren't afraid to do something, it would help. Healthcare, yea sure!!??
Updated on 04/19/2016: Since the last post I was given a primary care Dr. that United called and had me on the phone at same time again to make appointments for my husband and myself. So I made his appointment and held off on mine because I didn't like the reviews on the place. He was to see the Dr. but when I called to confirm it I was told he was seeing a Patricia. Anyway he waited for over an hour in what sounded like a zoo when he called me from there saying they are even taking walk-ins but telling him nothing except they don't have a room for him. Turns out I called there when he got home and the Dr's wife is the receptionist and told me Patricia didn't get into work yet!
Another wasted trip, time and money from work again. I find another Dr. finally that's in network and not too far. Great, I call UHC, let them know I found a Dr. definitely in network for primary care Dr. She tells me, "Yea, you can't change your husband's Dr. and there shows actually no relation and consent for you on his insurance that the girl this morning yesterday and the other 600 reps over the past five years weren't supposed to let me handle his insurance!" So they look to find a problem obviously because that authorization form was signed from day one, five years ago and I never ever had a problem calling on his behalf. The reps actually laugh in my ear and do the "I'm sorry for your trouble" script. Watch out for this company and AARP who I learned is affiliated with them. I think the reps laugh because they know they are getting paid for this aggravation that they think is funny and they do not have this insurance themselves. Health "care"??!
My financial counselor said that my procedure was covered based on the UHC's Policy that she read online. So, she submitted for me to have this procedure authorized and it came back denied. UHC could not give a reason. They said that the policy that the financial counselor read online was "in error." It made no sense, so I have wasted much of my time calling UHC and was transferred to a few different people. Even the clinic member could not give me an explanation. So she said she would send this off to a case manager. It's been two weeks and I have not heard from anyone. I really don't think their own employees even understand their own policy. I am extremely disappointed and has caused much stress in my life. It's all about making money these days for these big corporations. Customer service is always last.
Health coverage was to start on 1/1/16 did not get put into their system until 1/15/16 and did not receive my cards from them until 1/16/16. Had a prescription filled on 1/4/16 that would have cost $12.76, however due to not having insurance card was charged as if I did not have insurance at the price of $69.99. Requested over the phone and in writing reimbursement of $57.23 which was denied by the Resolutions Dept. Numerous calls to UnitedHealth One and each call I was on hold for 20-30 minutes before reaching a person. Terrible customer service.
I decided to try United Health Care because they seemed to offer the best policy. True the deductible was much lower than the other major insurer offered. I remembered my grandma had used them and liked them. That was before all the healthcare requirements. I applied and gave them the first payment info. I never heard from them - no insurance card, no bill, nothing. I tried to access their online site. It says I do not have access and I must call. No one could find my policy.
Today they said I never paid the premium. I said I gave info. They don't have it. They said they sent all the insurance information to my address. I said "Did you send it to (address)?" They said "That's not what we have." I said "That is my address." The girl argued with me. I asked if they had my address from last year, before I moved. "That was not it." I asked what they had. They said they couldn't tell me. I told them I never got any info. They said they sent it. I said "Not to me. You didn't!"
I was told to go to the affordable healthcare site and change my address. I said the aca had my correct address and could I change it now. I was told no, I HAD to do it on the affordable site. I would not be allowed to access their site and they could not change my address unless that site sent them the info. I cannot pay them online with no access. She refused my payment since my address is incorrect. I can't find out where they sent my info. I am ready to just give up on them and I haven't even gotten to the point of a doctor yet! This has been a nightmare!
On the UHC website, I researched several doctors to use under the Compass Balanced plan through healthcare.gov. The bronze plan I chose did not have my current doctors but I thought I could get by with the doctors I saw on the website. The individual plan is $685/month - NOT CHEAP. When I tried to make annual check up appointments, I found out that none of the doctors that I found on the UHC Compass Balanced website actually take that plan! The famous bait and switch routine!
The most infuriating thing is that because of the ACA imposed upon us by the dictator in chief & Pelosi, I cannot change plans even though I am disgusted with this plan. This is how the ruling party treats the minions, like slaves that have no brain to think for ourselves or demand good service or we will switch to another provider or at least a better plan. If I am unhappy with my home or auto insurance, I am free to shop at will. If I am incredibly unhappy with my healthcare plan, I am NOT free to shop until the next 'open period'. What a rip off the ACA is - to the participants and the American taxpayer who has to pay for this crock of mess.
My wife needs a spinal fusion. MRI results provides proof along with a Neurosurgeon with 15 years experience - they say it's not needed - they don't want to pay for the surgery. They will not say why or who made this decision - it could be anyone, who knows? She is becoming dependent on narcotics to be able to dress herself etc. United Health Care is the worst company we have ever dealt with. NEVER EVER choose them for your insurance company. There is NO Governmental Agency to police these companies - we are screwed.
United Health Care is HORRIBLE!! My husband and I signed up on December 15th, 2015 and paid our first premium the same day it came out of our account on December 17th, 2015 and was suppose to be effective January 1st, 2016. Jan. 1st came and our insurance info didn't come, no cards, no information packets. So we called they said we didn't pay for our insurance so we need to make that payment in order for us to have our insurance activated. I told them it was paid and I have proof it came out of our account. So after countless phone calls and wasted hours they found our payment... but not till Jan. 15th!! I wasn't notified till Jan. 21st that they found it!
Well due to their mistake we weren't able to use our insurance for the whole month of Jan. because they lost our payment. I asked for a credit or refund for those days that we lost because they lost our payment. I was 1st told they couldn't do that over the phone and I had to email. Then I was told they can move our effective date to Feb 1st and waive our Feb. payment. I initially said yes but after talking to my husband he said no because we would get a tax penalty if we didn't have insurance for a full 12 months. So I called to say "no move it back to Jan 1st". At that time I was told they didn't know what I was talking about and that isn't something they can even do and don't know who told me that and they have no record of anyone telling me that.
So I call and email several more times trying to get a credit for the days I wasn't able to use our insurance because they lost our money for a whole month. Now it is March so I log onto my account at UHC and I am being billed for over $1,000 (my premium is only $229.78 a month). I am being charged for 2 of the exact same plans! 1 effective date of Jan 1st 2016, and 1 effective date Feb. 1st 2016. I call and cancel the Feb. plan. They say they don't know how that even happened legally etc. It is now April 6th 2016 and I am still calling trying to get something taken care of. I am not even asking for a refund just a credit to my current bill for the days I lost. I am currently on the phone as I am typing this. It has been 49 minutes... mostly me being on hold and guess what they just offered me? To move my effective date to Feb 1st, 2016. I DO NOT RECOMMEND paying any money early to this company, because they might lose it for a whole month.
I will not be renewing with this company next year. I had to wait a month to get approved for dental work after a tooth was broken, this has never happened to me with other dental plans. There is a separate website each for medical, dental, vision, and to get prescriptions in the mail, 4 total!! Because I turned 65 last year I can't be enrolled in Washington State Health Care anymore. It's much better and cheaper than Medicare/United Health Care.
I signed up for the $400/month bronze plan with prescription savings plan. Once I signed up for that plan, I then found out it doesn't cover mail order prescriptions or most prescriptions in general. I called for assistance and basically was told, "Sorry we can't do anything..." I basically was lied to or tricked prior to signing up for this plan, and now each time I call it's basically "too bad for you." Also, while applying it asked for my PCP, so I put their name in. Have been seeing this specialist for years now. They put some random doctor as my PCP. Never heard of him.
Was told I cannot change it to a specialist, has to be PCP. So now I guess I have to go see some random doctor I don't know to get prior authorization for some of my medications. Which makes no sense, because in the end the health insurance is basically paying for a random doctor when I have my own. I can't wait 'til next open enrollment so I can cancel! I am in the health care field, and I make sure I tell everyone about my problems with United Health.
Terrible customer service and why pay for health care when everything gets denied and has to go through some black hole process? I have spent hours and hours of my time and gotten nowhere with this company and 2 appeals for a smoking cessation drug that is covered on my plan but they don't want to pay and have ruined a 15 year relationship with my general practice doctor. Now I'm told no more appeals and I have to wait 180 days to go through this process again! Yeah right! If any company treats their customers this badly they go out of business!
This company will go down, just a matter of time. I have never ever in my entire life had this many problems trying to get an insurance company to pay for anything let alone a drug to quit smoking so it doesn't cost our healthcare system more money. I think I now have high blood pressure after 30 calls to them in 5 months and multiple conversations with supervisors and still have gotten nowhere. I will not be paying for this out of pocket given this drug is covered under my plan and THEY WILL NOT BE DICTATING MY HEALTHCARE. First experience with this company in my life as I've always had Blue Cross and they have lost a customer and I will be going up the chain with my dissatisfaction with this company.
On March 7th, 2016 I called UHC AARP to inform them wife had passed and they still took the 100.00 plus dollars from our account. They said 10 to 14 days it would be back in. They lied. Today is the 23rd. Called them. They said I'm not the insured, can't talk to me. I haven't eaten since the 8th. What they pulled out of our account was the remaining money in it. Lady said "sorry for your loss but can't talk to you," so be careful. They want your money but really don't give a damn about you. I cancelled my AARP membership. Not giving them anymore money. Going to bay area TV station with this. Maybe people will realize AARP only in it for themselves. Yea, I'm dorked off.
I signed up for United Healthcare in Alabama after disability caused me to resign my position in a hospital after 35+ years. After signing up... the nightmare began. I live on the Georgia/Alabama and my physicians are all in Georgia but I could not sign up for Georgia coverage even though my doctor is only 10 miles away. I am not able to drive, so all appointments have to be arranged with someone to drive me. So I made an appointment to see a doctor 30 miles away after being turned down by no less than 10 doctors on their so called plan because they no longer accepted UHC. I showed up for appointment, filled out 10 pages of paperwork, paid my co-pay and waited. I had informed receptionist I was being seen by a Pain Management Specialist in Atlanta, and she said "no problem." :)
I walked with my walker and mother-in-law (who drove from Florida to take me and try to get treatment for my ongoing debilitating back issues.) After getting x-rays, the doctor finally came in and informed me he could not treat me because it's their policy not to treat pain management patients. I told him I just need a primary to refer me for further evaluation because I did not wish to continue up to take medication and I wasn't asking for medication, but to be re-evaluated by specialists. It didn't matter, they would neither treat me nor refer me. I had to call the insurance company for another doctor. Spoke to insurance company again, going through the automated push 1... carousel. Finally got someone, explained situation, and he said he would find me a doctor or get an exception so I could go to Georgia. While on hold, guess what? I was disconnected.
I called back again, phone carousel, could not speak to previous person even though I had his name. She said they can't do that. Great. So for about the 19th time, I'm telling my story and I gave her my number in case we were disconnected and yes, we were. Called me back at 5:00 at which time all doctors' offices were closed. She told me they don't make exceptions so the other representative was incorrect for telling me this. Called them the next day and they finally found a doctor and I verified by three way call that they would see and treat me. Great! This is March 10 and appointments won't be until the 23rd. So asked where the nearest Urgent Care was that our plan covered... Almost 90 miles away.
Now I'm sitting in the car Friday in the parking lot in Carrollton, GA while my mother in law goes in and gets me groceries. I'm hurting so bad I cannot operate an electric scooter. She ask me if I had enough pain medication, and I said yes, I had more than enough to kill myself! So she puts me on hold, comes back and says she's going to transfer me to a help specialist and I said "great, thank you so much", and guess what, I get transferred back to the original phone carousel!!! When I finally got a person, I lost it! Needless to say the temper I had controlled all these weeks just exploded!
They put someone with an admitted bag of pills who has mentioned killing herself on hold for 23 minutes (yes I forgot that part) and then sends me back to the original phone recording. I asked him his name so I could leave it on my suicide note and he gave it to me! This is all the absolute truth. This is why my mother in law drove up here, to see me fall apart at the hands of United Healthcare.
So run, don't walk as fast as you can. They are so polite on the phone until I realized after all these calls that it was all scripted. So what am I going to do? See the doctor this Thursday, and if I'm not shown proper care and respect, I'll be packing my bags and moving back to Georgia and then they can help me to transfer my health care to Georgia. It will mean leaving my husband and my house of 15 years, but I really don't know what else to do. After caring for patients for over 35 years, I am left by the very system I put my life into.
My daughter was born on June 14, 2015 and had one month of coverage with Kaiser before she was switched to a United Healthcare family plan. Her coverage with United Health Care started on July 6, 2015 and her coverage with Kaiser ended on July 14, 2015. United Health Care has repeatedly denied claims AFTER July 14, 2015 (when my daughter's Kaiser coverage ended) on the basis that she had another primary insurance that should be billed. I have called United Health Care at LEAST seven times to resolve this issue. Every time the "customer service" agent assures me that the issue is resolved and that the claims will be paid, but this is never the case.
On March 11, 2016, United Healthcare took back money they had already paid to my pediatrician for one office visit on 8/6/2015 and one well baby visit on 8/17/15 (both well after her Kaiser coverage ended) in a total amount of 1365.00. I have attempted to resolve this issue numerous times with United Health Care and they have not only refused payment of valid claims to my pediatrician, they have refused claims under the same false statement (that myself or my daughter has other primary insurance) for several other medical treatments that are clearly covered by our plan. They have refused payment for these treatments even after I contacted them about this error and (supposedly) reached resolution. Now they have rescinded previously paid funds that are CLEARLY owed by them to my pediatrician, leaving me with the bill.
While speaking with the supervisor at United Health Care, she revealed to me that United contacted Kaiser on 3/16/16 to confirm that my daughter did have coverage with Kaiser on the start date of my United policy (7/6/15) and used that information to deny claims on 8/6/15 and 8/17/15. United also called my husband on 3/16/15 to ask him if my daughter and I have Kaiser insurance and he said no.
I would like United to tell me why a United employee contacted Kaiser to research their responsibility for claims made on 8/6/15 and 8/17/15 but never actually asked Kaiser if we were insured through them on these dates. I am concerned that these actions are a systemic issue that is potentially designed to delay payment on legitimate claims and would like to receive comment from United.
When I purchased this policy after moving to MS in the Fall of 2015, I was told that Dr. ** was in network and I could still use him as a Primary Physician. I still saw Dr. Calvin ** or his nurse practitioner until the end of 2015, and the claims were paid. I have been going to Dr. ** over the past month for high liver enzymes. When I received the rejected claims, I contacted Dr. Mullins and he nor anyone in his office were aware I could not be seen there anymore. He stated I see patients from MS who are insured by United Health Care all the time.
I made an appointment with Dr. ** and upon arriving, I was told by the receptionist that I should make sure I have been assigned a primary care physician and that Dr. ** was in the network, because many patients are seeing their claims denied. I called back Member Services back and the agent told me that I was not assigned to Dr. ** and that he was not even in the network. She emailed me a list of providers and his name was listed.
I called Member Services again and was assured that Dr. ** was in the network and that I had been assigned to him. It appears that many of the employees of United Health Care are not familiar with their jobs and how to do them. And, the information provided to patients and providers re: coverage does not clarify the requirements to get a claim paid, and that this is not an isolated case.
UnitedHealthcare probably saves about 20%. By going against standards of the industry through various fraud. The insurance industry is now being enforced by former UHC execs. The head of Medicare is a former CEO within their organization. Physicians and patients both lose and since their CEO's pay is mostly done through stock options, it makes more money for him to deny claims boosting the value of their stock at that very moment.
If you are a physician’s office and you request authorization, be prepared to fight in order to get that authorization. Once you get it, be prepared to have to send in all notes from whatever was done. Expect delays and expect them to pay only a portion so that maybe in about 9 months you might get paid from all of it with about a 20% lower payment than that of even Medicare. UnitedHealthcare is in the provider world is this. Requires 4 times the work, and gets 2 times less the pay out from any other insurance. Nobody should be allowed to do what they have done and continue to do. They really should be shut down as a company.
The very worst you could possibly imagine. My wife had Care Improvement Plus as her medicare advantage PPO. They merged with UHC and it has been nothing but a disaster since. I would definitely advise against this company!
United Health Care Company Information
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- United Health Care