United HealthCare Complaint - The Worst Insurance Company-Providers/Insured beware
TENNESSEE -- I am a in network provider for United Healthcare, for now. UHC goes out of their way to avoid payment to providers by demanding clinical notes and records with no reason at all but to put up clerical roadblocks. I received denials asking for the patient notes because "information on the claim submitted is either missing, not ledgible or incorrect". When I called and asked what information is missing or wrong they can not answer. When the reason for requesting the notes for a patient is invalid, why are the notes still required for payment to be made? They also ask for Clinical Submissions to be sent in to ACN Group (owned and operated by United Healthcare) for approval. Sometimes it is required and sometimes not. However on my last 6 UHC patients who did not require Clinical Submission, all of the claims for these patients were denied because clinical submission was required. When I called to find where the problem is, they apologize and state they made a mistake (actually dozens) and resubmit the claims only for me to receive denials again for the same reason. Finally I found that Clinical Submission was required for all 6 patients and now are refusing to pay because of their error. I have many UHC patients that will be effected by me getting out of network but I refuse to continue to do business with such an unethical company and am filing a complaint against UHC with the Insurance commission in Tennessee. I sincerely hope all providers who are in network with UHC does the same if for no other reason but to make them answer for their behavior. PLEASE, if you have an option for which Insurance provider you use, chose ANYONE but United Healthcare. Don't make your Doctor go through what I have. You and your provider deserve better!
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