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, pursuer 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!
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.
If you are considering insurances, DO NOT consider this one, you will pay the price. After visiting the doctor last month, I come to find out after receiving both a doctor bill and medical lab bills that I wasn't insured. I just about panicked, and I called them to have them tell me that even though I had paid my bill, had documents stating I was insured, I somehow happened not to be.
After over 4 hours on the phone, (they don't have a universal computer system) and accepting I will have to pay my bills with no explanation, I received a letter from United Healthcare stating I had been insured that entire month. Now, I called back and they are claiming, oh yes, it was our fault, in fact you are insured. So, after being transferred many more times, I got someone who claims that they will contact all of the labs and Dr. offices and send a check to cover what they should with an explanation.
Now, this isn't the first time I have had a horrible experience. I am honestly expecting them to screw this up to, so I called the billing departments and updated them myself. They seem to mysteriously uninsure people. My sister who had been insured through them gave birth, and found out a month later that they had decided to cancel her insurance claiming her labor and delivery weren't going to be covered by them. In the end- THREE YEARS later she won and was awarded that coverage, although she is still waiting for the $. So, save yourself time, give yourself peace of mind and don't even consider United Healthcare for your insurance, you will be sorry.
I'm not one to air out my life issues. However, a story needs to be told. I was diagnosed with Breast Cancer two and half years ago. Since my chemo, surgery and radiation - I have been in remission. So, call me a survivor if you will. The one thing I haven't managed to survive is the fear of Medical insurance. When I was diagnosed I worked for a Bank and had wonderful insurance. We all know what happened to some of the banks - I lost my job in the middle of treatment. However, my employer and insurance provider stuck by me and I will never have one bad word to say about them.
Shortly, after my battle I was able to find a job and stayed on Cobra until I was able to get onto my new employers policy. The first six months were great, never worried, provided them with my previous insurance information and they paid all of my bills. Then my employer changed carriers four months ago and I just received a notice in the mail yesterday that my insurance had been terminated due to pre-existing condition.
I've never had one day laps of insurance since my diagnosis. I've paid all of my payment and copays etc. I haven't contacted UHC yet, I will do so tomorrow. The thing is I've been going to my yearly followup appointments in the past few weeks and had I known my insurance had been terminated well, I wouldn't have racked up a hefty $5,000 in bills that I now must figure out how to pay. The kicker, I made it a point to call an Attorney before I gave up my Cobra Insurance to go with my current employers. I was advised that they cannot consider my condition pre-existing unless I had a gap of insurance and he told me to never have one day without insurance, and I've done just that.
It's not fair for Insurance Companies to punish people in this situation. I never asked for Cancer - and now that it's out of my body - I feel like I'm dealing with a whole different form of Cancer - It's called BULLCRAP Insurance Companies. If I didn't need you so much - I'd tell you to go ** off.
ATLANTA, GEORGIA -- Since becoming a member of United Healthcare about 31/2 months, I have been denied, or put through the authorization process, about 5 times, medication that my previous Insurer has paid for, without question. They farm out prescription services to Medco. I have followed their procedures, and still they make me change to a cheaper medication, even though my doctor thinks he is prescribing what is best for me. Their job is to "be the judge" of what you get. If your plan does not cover what your doctor thinks is best for you, you and your doctor have to follow an appeal process.
They will spend hours and hours on the phone, and still keep a patient from getting something they don't want to pay for. They will send you an authorization, or an appeal form, but by this time, you have already left your doctor's office, and are waiting. Sometimes you can get your meds, and sometimes you just have to deal with it. If they are so worried about their bottom line, they should be cutting better deals with the pharmaceuticals, but they already do that, don't' they? Or maybe raise their rates. Oh, yes, they have done that too. They even want me use a pill cutter to cut my one med in half, just so they don't have to buy both dosages.
Since most of the competing healthcare insurance companies been gobbled up by Aetna, United and others, their simply is not as much choice for employers to shop around for quality, affordable plans for their employees. Period. If members of the U.S. Congress had to deal with a fraction of this hassle, they would be changing the law in a New York minute! Keeping people out of the hospitals by the use of drugs already is a proven approach for everyone. They do not even have a form, that I can find, that includes a space to enter a date, service, doctor, or billing code, so you can use it to get reimbursement, without having a doctor bill with what they want on it.
This is not practical for the insured, at all. Why keep that service or medication from us, so that we get sicker, and risk an even bigger claim? The answer is that they know we have no one in our corner, as they do in Washington. I urge people with issues of abuse of power, and denial of service to let their thoughts be known, or it will never change. I also urge anyone who is trying to buy health care insurance, to find out all the details you can before you sign up, because after that, it's too late.