MINNETONKA, MINNESOTA -- I just read an article that says, “Hospital executives rank United Healthcare as the worst insurance company in the United States.” (It is available here: www.allbusiness.com/health-care/health-care-facilities). This will come as no surprise to many members and providers alike. Like many others, I want to share my recent experience with United Health Care so that people can decide for themselves whether or not this is the kind of health insurance they feel they want to purchase for their families.
I am a neuropsychologist and was asked to see a UHC member for neuropsychological testing. I filled out all of the appropriate forms required by United Healthcare and received a telephone call authorizing me to test their member. They gave me a cap on the hours (13 hours total) and an authorization number. I provided the services as promised and then sent the appropriate claim to the United Healthcare offices.
When they sent me the check, there was a note on the Explanation of Benefits saying I had agreed to a discounted fee (an approximately 50% discount, mind you) through an organization called MultiPlan (If you haven't heard of them, you're in for a treat. They contract with insurance companies to try to persuade clinicians to agree to a reduced fee and they get paid a percentage of what they "save" the insurance company.) Needless to say, I do not and never will have an agreement with this company, as I do not support business practices such as this.
When I contacted United Healthcare to straighten this out, they told me I had to deal with MultiPlan. Multiplan never answers their phone (I wonder why) so I got nowhere until I filed a complaint with the Better Business Bureau. This got the attention of **, a Consumer Affairs Advocate for UHC (1-800-842-2656). She researched this issue and came up with a fabulous solution!
She decided that United Healthcare had authorized this treatment in error and paid me in error AFTER I HAD RENDERED THE AUTHORIZED TREATMENT to their member. They then "recalculated" the claim form and decided that I actually owe THEM money! They have asked for the entire amount back ($966.68). They have a very fancy way of explaining their "logic" and have added that the original error was with their processor and they have arranged for her "to receive additional training or other intervention as appropriate."
With a second patient, they attempted to get me to accept a reduced fee through MultiPlan for another member and I declined. After that, they refused to pay me AT ALL for the services I provided to the other member while he was in the hospital. United Healthcare also authorized these services and the correct authorization number was submitted with the claims.
In both cases the services were requested by a physician and approved by United Healthcare. The services were rendered as authorized and the appropriate claims were filed. Unfortunately – and this really is the sad part – both of these claims will have to be paid in full by the members. These claims total thousands of dollars.
As I'm sure many of you know, United Healthcare is the focus of a Class Action Lawsuit in New York because of their questionable business practices. When I Googled “United Health Care reviews,” I was SHOCKED at the number of complaints against this company. How is it that they are getting away with this kind of behavior?
FLORIDA -- I had to changed to my husband's insurance since I retired. I have taken ** for undiagnosed chronic pain. I have pain in my right shoulder, my lower back mainly on the right side and pain in my right ankle. During a trip to Wyoming, I pinched the nerve in my lower left back and had horrible pain shooting down my leg. I have seen two specialists and had three lumbar injections and two nerve procedures where they burn the nerve connections. I take ** and ** for the pain.
Now United Health care is denying my ** because I don't have nerve pain due to injury to spinal cord. Also they state if I can't take a tricyclic antidepressant or ** I am legible for **. Guess what! I can't take either. And I have chronic nerve pain. Go figure.
USA, MARYLAND -- Coverage ended 2/28/15 with $0 premium balance due. May 2016 got premium balance due $60.52. Able to still go into UHC account to print payments made from 2014 - 2015 time of coverage. Found they changed payment amounts. Still had emailed payment confirmations also. Had to get CC statements to prove amounts. Called UHC. Talked to Jessica to tell her I am waiting for CC statements since I went paperless and it is almost 1 1/2 year later. Please note my account. "No problem" she said.
Next day Mark calls from UHC asking for payment. WTH!!! Both times I feel they pretended to note my acct. I spoke with James 7/18 to say I have proof payment made but amount changed. He informed me I can only and repeat only send my proof via email or fax! No mailing. WTH again.
I'm lost in words since I had reported them when we had them for making coverage a nightmare. State Attorney's Office short staffed and because I was no longer with UHC they could not investigate them. Bull. So I am hearing others having the same issues with not paying for script, need preauthorizations again & again. Saying they did not have payment when did. Now how many are getting premium balance due over a year later???
I started work with a new company that uses UHC. I live outside of their main area in the Northeast and when I used their website to look up providers I found none in the area. When I contacted them about this they told me the same thing. I cancelled the coverage and went on the very expensive COBRA plan available due to my old job. My HR department eventually gets to me and after further research finds that a different third-party website shows that I do have providers in my area.
It is unacceptable that their website does not work properly and that their staff is unable to provide the information I need to make my insurance choices. Their misinformation has cost me thousands of dollars, countless hours, and a fair amount of stress all while I've been trying to deal with a serious recent medical issue. If UHC is this terrible at providing simple information, I worry about relying on it for any serious medical issue.
SALT LAKE CITY, NEVADA -- I was hospitalized in May of 2015. I first went to urgent care and was transported from that facility, by ambulance, to the emergency room. I was diagnosed with pneumonia, sepsis and was in renal and respiratory failure when I arrived. I was intubated and put on a ventilator and spent 8 days in ICU. The policy I had, had a $5000 deductible and a $6250 out of pocket maximum. I have satisfied the out of pocket max but I am still having problems getting UHC to pay the physician claims.
On my first appeal, they responded that they had not received the H&P and other medical records to support the claim. I responded with another letter and included all the clinical notes from each day in ICU. I then received a response with another denial saying that they could not find a claim for this appeal. The provider listed on the second denial was my new insurance carrier which was not effective until 11/1/15 and was never mentioned in any of my letters. The letter also stated that I had exhausted my limited appeals.
I responded with a third letter, highlighting all the information and I insisted that a supervisor look through all the documents and respond back to me by phone. I am giving them one week to respond and then I will go the state regulators. I have all the documentation and I am sure in the end they will have to pay the claim. I have never experienced such incompetency and poor customer service in my entire life.
MARYLAND -- To start off, I've had terrible experiences with United Healthcare since I started their coverage a few years ago. It's come to a head recently after a coordination of benefits issue meant that they paid a hospital bill for my husband and then retracted the payment from the hospital. TWICE. Now the hospital, of course, is coming after us for the 6,000+ bill.
I have called and emailed countless times over the past 2 months. I've sent emails. I managed to get direct lines to 2 different people and have been leaving voicemail after voicemail, which has been ignored. I've sent the paperwork and letter from the other insurance company verifying the coverage dates and confirming that United is responsible for the bill. Nothing. And the hospital is threatening to sue us now b/c it has gone on for so long.
Finally, today, I left a nasty review on their FB page. I didn't really have much hope for this other than maybe warning others to try to find different health insurance. Not 10 minutes after I left the review, a member of their social media team contacted me. He got all of the information on the problem and filed an escalated ticket to get it handled quickly. AND he called the hospital and they've placed a 30-day hold on the account, with no collection activities, to give United time to deal with the coordination issue. So, what can I say? Um, the rest of United is TERRIBLE but their social media department is great, so far anyway.
PENNSYLVANIA -- I have already written to the CEO of UnitedHealthcare so I will be brief. This company has been stupendously inept. Here is a summary of their excuses for not paying...
Each correction to their process takes an entire billing cycle - hence 10 months have elapsed with still no resolution. The hospital has lost patience and started debt collection proceedings against me. UHC assured me they would expedite a "Cease to Bill" letter - I have had to ask twice and still no letter after more than 2 weeks. I have noted everything so next I will be taking my evidence to the Ombudsman.
KINGSTON, NEW YORK -- The company says they cover hearing aids. They say in their contract they will give you $1000 per ear over a 3 year period. The problem is that they will not approve any hearing aid purchase over $1000 dollars per ear and won't let you pay the difference out of your pocket. They only allow your Dr. to bill you $1000 per ear and cannot charge you amount over that.
They try to force you to buy hearing aids from Hi-Health innovations, that is a subsidiary of UHC (A SCAM). The hearing aids are cheap, ($800-900) per ear and will not work for me. The FDA has a cease and desist against this company for wrong practices. They also try to force you to get other very cheap hearing aids that will not work for me.
My audiologist has gotten burned many time by UHC and is even an in-network Dr for UHC. My Dr has not one good thing to say about the company. Most companies don't offer hearing coverage, but if they say they do, then they should and not mislead you or force you to buy what they want you to wear. I think it time to shop around for better insurance. I hope a lawyer looks over their contract and makes them change the wording in their contract.
KATY, TEXAS -- I have had insurance through most major carriers in my 40 years of working and some were good and some left a little to be desired, but United Health Care is undoubtedly the worst insurance company on the market. As with other stories here, they lie, they misrepresent and they deny coverage for coverage they say they in fact do allow for.
I am changing after the first of the year and will never use or recommend this insurance to anybody. My wife is going blind and she needs a medication for her eye (which Aetna when we had them had no problem approving) that UHC will not cover after lying to us and her doctor and saying, "Sure we cover that." It is $200 a week and a medicine she will have to use for a couple of years before she can get a cornea transplant something else they don't cover. All I can say is buyer beware when dealing with these crooks.
SOLANO COUNTY, CALIFORNIA -- United Healthcare takes over your Medicare makes decisions on your medications above and beyond your physician's recommendation. The pharmacy Optum RX has denied 2 of my 90-day supply medications informing me that the 90 day of each of these 2 medications were all I was going to get for a year supply and all refills are denied. My physician has appealed this decision and it was disapproved.
I am going to appeal the decision once again but these actions are causing undo stress and anxiety. I am retired and my insurance is through Calpers I had to change plans because my previous Blue Shield Ins. hadn't signed a new contract with my physician's medical group Sutter Regional. I feel sorry for anyone that has to deal with this insurance co. I wouldn't even give this company one star. I cannot wait till open enrollment and get my Blue Shield back. Someone needs to look into an insurance company that defies a physicians diagnosis and prescriptions. I writing this because if anyone is considering United Healthcare they might do a little research first.