SALT LAKE CITY, UTAH -- United Healthcare mailed me five provider appeal requests I never made. I got four in November 2014 and the last one dated December 5, 2014. First one gave the name of a company and said I made a complaint against this place and said they sent a decision explanation and since it was a duplicate, I couldn't appeal it. What complaint and what duplicate complaint? I've never made one. I faxed UHC in November 2014 and informed them that I did not make a report and for them to correct it. Ignoring tactics they use. They sent me four more of the same.
They were dated November 4, 7, 17 and 25, 2014. UHC indicated they put them in my patient ID files. The last one was December 4, 2014 and dated with an individual's name as provider appeal request I never made. I faxed provider complaint on a horrible P.T. records content that UHC had paid for and last phone contact about that was October 27, 2014. Last fax regarding that was November 2, 2014. I never heard back on the issue about P.T. session.
I got harassed by UHC with nut job fake reports instead, gee I wonder why. Also November 3rd and 4th, I got two phone messages to call UHC about another made up nonexistent report. Saw bad scene, I was done with UHC. No more phone contact and I looked for another insurance. I would have had to have made a report and received a letter back on an appealed decision in a specific time frame long before the P.OT.. complaint to have even exist, which it was not.
They have NO phone connection or faxes or letters on fake reports. I got 2 answer machine calls on December 5 and 8, 2014, from service coordinator UHC, phony, prank sounding message telling me to call her about my requesting multiple therapy times. I never did! I stopped all calls. October 27, 2014 was the last and only sent a few faxes November 2014 for UHC to take reports I did not make out of my files. And I did not of course, pursue initial complaint.
I left UHC in December 2014. They also apparently sent me to physical therapy two other times , pulling a stunt of having my significant medical condition completely left out and had my other med files hoaxed with as medical conditions magically deleted. My only opinion is all of the above. I have all of my medical records however. I've been trying to get all the fake files out and straighten the records out through other places, but not able to yet. I have not gotten five fake file reports I never even made. I do not have anything to do with UHC!
MARQUETTE, MICHIGAN -- I retired in December 2011. After retiring, I had to pick up my own insurance for my wife, son, and myself. Our premium was $560 per month with a high deductible of $2500. This insurance did not cover anything. I had hand surgery. The doc schedules me for trigger finger surgery.
Two weeks later, I have surgery. I then need therapy on the hand. The therapy was $3000. 3 months after hand surgery, I get a bill from the hospital saying United not covering surgery. I get a $2000 bill. A simple hand surgery cost me $5000 out of pocket plus my premium. I blame the hospital also for getting authorization for surgery, but not checking to see how much the insurance was covering. Only $500 was covered.
My son had a shoulder injury. United covered the MRI, but I got stuck with another $3000 in therapy for my son. My wife had a bunch of women's testing. We get a bill showing United is covering $9.00, yep, $9.00 out of a $150 charge for a test. I figured I spent about $6000 in premiums, and about another $10,000 in out of pocket money for things not covered. From what I guess, only about 5% of everything was covered.
I am getting a new insurance plan. This plan really sucks. You could do better putting your premiums in the bank and paying cash for medical cost. Thank God nothing serious happened to any body in my family while we had this insurance. Golden Rule should be called Golden Shower. I plan on researching to the penny what I paid and what United Health Care did not pay. It is amazing. Do not use United Health Care Golden Rule. **
TRUMBULL, CONNECTICUT -- One star is way more than they deserve. I pay a fortune for the worst health insurance I've ever had. In order to avoid a $1,000 deductible, I have to get my x-rays and lab work done at facilities other than a hospital. I called United Healthcare to find out where I could get blood work and an x-ray done without incurring the deductible. Turns out there ARE no places where I can get both done, which is an outrage in itself.
So, I went to 2 different places, 20 minutes apart. A couple of weeks later I got a bill for the X-ray! They told me where to go, then they charged me for it. It was in-network, on their list of approved facilities, and they sent me there, but I still had to pay for it. Great work, United Healthcare!! You're really on the ball there.
TENNESSEE -- My father needed to have a CT scan per his doctor to make sure that his cancer (has been cancer free since 2000) had not come back. His claim was denied by United Healthcare. The reason stated was "You have cancer in your nose and throat area. You have neck pain. You have a sore throat and pain in the roof of your mouth. Your provider suspects spread of "cancer" to your brain. Your provider asked for a CT scan of your head/brain with and without a dye called contrast."
The letter goes on to explain what a CT scan is and what a MRI is and then states that "cannot be done for medical reasons and you have a brain function problem such as mental confusion, change in vision, slurred speech or a new severe headache."
My father receives this notification and is devastated!!! First of all, he went the doctor with throat and pain in the roof of his mouth. He NEVER complained of headaches, mental confusion, change in vision or slurred speech. He contacted his doctor and the head nurse called back and apologized over and over again since the information that was sent to him was a LIE!!! She confirmed that no one in the doctor's office provided that information to United Healthcare. It appears that someone that works at United Healthcare falsely added this information/LIES to his records so that the medical services requested would be denied.
I am sure this is not the first time that this has happened to customers of United Healthcare. Please do not use United Healthcare for your medical needs because they falsify medical records so they do not have to approved medical services or items. How many others has this happened to? Who can help with this type of fraud?
HEALTH INSURANCE, OHIO -- My daughter needed a neurostimulator placement for Occipital and Trigeminal Neuralgia. The surgery was scheduled for April 2014. The doctor's office sent all info to UHC for approval. The approval was received, dated 3/5/14. Unfortunately, the doctor had a family emergency out of the country and the surgery had to be cancelled. When he returned, the surgery was rescheduled for July 2014.
6 days prior to surgery, we received a call stating that UHC denied the surgery. Why? Pick a reason! "Not a covered benefit", "no medical evidence to support the procedure", or "waiting on a peer-to-peer review". Some physician, sitting in his "Internal Medicine" office in Illinois, decided that my daughter, who has about 10% quality of life at this point, did not need this! A neurosurgeon, after an extended consult, decided she DID need it, but this doctor who had never met her decided NO!!!
LOS ANGELES, CALIFORNIA -- STAY AWAY FROM PACIFICARE AND/OR UNITED HEALTHCARE!!! Let me start off with my family history, it's an important part of this story. My mom's mom died when my mom was 13 of a ruptured brain aneurysm. My mom's older sister had 2 ruptured brain aneurysms, the second killed her. Obviously any time my mom would go to a doctor and fill out paper work, that would be brought up.
My mom has had bad migraines her whole life (her sister and mom never had any apart from feeling their ruptures) but the last 7 months she's been having the worst headaches of her life. Any time she would go to her Pacificare assigned doctor, (we're on HMO here) her doctor would tell her it's just bad migraines and probably menopause but would assign pills for migraines and muscle relaxers. 2 weeks ago the pain was so bad my mom went back to her and after she again tried to prescribe more pills my mom demanded an MRI because of her family history in which the doctor replied "Well it's not like they died of migraines." Thank you for your input doctor.
Anyway, we finally get an MRI on a Saturday and as feared there is a substantially large aneurysm that thankfully has not ruptured. The people at the MRI place gave us a CD with her images and told us to go to her doctor on Monday and if you get another bad headache this weekend, go to the ER with said CD.
Monday rolls around, we go to the doctor at 9:00 am, see her relatively quickly and she says we have to go to USC Keck Medical school for an "emergency consultation". She tells us to wait for her call. 4:00 comes around and she finally calls us to tell us OK go they close at 4:30. Well, thanks, Keck is in East L. A. we live on the Westside. On top of that, the paperwork the doctor or Pacificare sent to the people at USC had nothing to do with my moms brain but instead was sent paperwork on a recent mammogram. In theory a PPO sounds a LOT better but I can't really speak for that because I've been HMO my whole life, but STAY AWAY from HMO at UnitedHealth/Pacificare.
CALIFORNIA -- It was the worst experience imaginable. Although Secure Horizons/United Healthcare policy allows a second opinion, my authorizations for a second opinion with an in-network provider were repeatedly denied by Health Care Partners, who were apparently connected with them. I had a cancer diagnosis & wanted to see another in-network doctor for another opinion.
It was only when the case was scheduled to go before an Administrative Law Judge that they relented. They did everything they could to make it difficult for the second doctor, such as refusing to turn over results from previous tests. After a great deal of difficulty (& after almost two months,) I was allowed to be operated on by the second doctor. As soon as the new enrollment period came up I enrolled with another company.
INDIANAPOLIS, INDIANA -- When my employer signed with UHC everything seemed to be fine. As time passed we found that UHC is very difficult to deal with. After a month they told several of the employees they would only cover certain prescriptions through the mail order service. I myself have been taking a name brand medication since 1980. The past insurance companies we have been with covered this script no problem. Well UHC won't cover it. They say I must take the generic brand which causes frequent stomach distress.
By the way did I say this medication is an anticonvulsant for seizures? No way I can stop taking the medication. Everyone I spoke with at UHC said they do care, but I somehow don't believe any of their scripted responses. This insurance company is the worst I have had. It horrible that they charge so much, deny so much, they tell you what they won't do and on top of that they transfer you from one ** to another. This company and their people are impossible to deal with.
NATIONWIDE, OHIO -- I was a Mid-Level Practitioner for this company (Evercare) for nearly 9 years. I was responsible for 6 Nursing Homes across 2 counties 45 miles apart. If you think you can see all your patients daily within 8-10 hours a day you are dreaming. It is a crime that the entire Evercare Field personnel are overworked, and the Evercare portion of United Health Care is a revolving door. In my tenure there I had seen a complete turnover 3 times. The pay ranges are adequate to start, but forget a yearly raise, even to the effect of a cost of living adjustment. They also are of the mind set to go after anyone who questions their practices.
If you do not like it, as a "at will" employer they will say "if you don't like it leave". What they forget is we are dealing with the sickest, most difficult patients. I would recommend to all the Nurse Practitioners and Physician Assistants to find another organization to devote yourself to, someone who cares about its employees and value their devotion to the patients. I for one worked 60 hours a week on average and after nearly 9 years I said enough, as I had seen so many great people used, and thrown aside.
Now all they hire is new grads from school who are looking for the "First Job". I have been in this occuapation many years and am nearly 60 now. This is the worse company I have ever worked for in regards of employee value. I guess I bought into the fact that they were attached to a large insurer. Just look at what the CEO is making yearly. $48 million dollars... I guess he must have gotten the yearly raises from everyone... Am I bitter? Hell yes, the system is broken and needs to be fixed.
I don't even know where to start!!! I have United Healthcare (NOT by choice, this is the only insurance available through my employer) and I am dumbfounded by the lack of knowledge of their representatives and to their policies. For instance, do you know that you are not allowed to call back any of the employees or the supervisors? I was told today that "we do not give out our numbers".
Therefore, when someone attempts to help you with a concern (I say attempt because out of 12 people I spoke with, not one of them has been able to help me with something simple) if you want to follow up with this person, you cannot. YOU ARE NOT ALLOWED. I am filing a complaint as soon as possible. My daughter is allergic to milk protein and one of the benefits that is "covered" is her formula. Well, every single time we call there, we are told something different. I believe that they do this on purpose so that you will give up and not file the claim, therefore saving them money.
I have literally spent the last 2 weeks of my life on about 15 phone calls, spoke with 5 supervisors (all of which is a moot point because they give you the wrong information and then by the time you figure out this information is wrong, you can't call them back because you are not ALLOWED to). Every single time I speak to someone I am told something different. I still don't have the issue resolved. I will tell anyone and everyone I know how awful this company is. Very angry customer and nurse.