UMR Health Insurance Consumer Reviews - Page 5

SALT LAKE CITY, NEBRASKA -- UMR company always delays payments asking for medical records all the time. Have been in practice for 25 years and never seen anything like this. They just do it to delay the payments as much as possible.

The website is slower than my 92-year-old grandma. If you want to see your claims, make sure you take a day off and cancel all your plans cause when you click claims, it takes hours if not days to download it. Companies must be sticking with the UMR cause it must be the cheapest third-party medical website in the whole world.

Well called UMR health insurance company today. First they tried to tell me, again, that records were requested and they were waiting. I told them that what they said 6 weeks ago until they checked another "file" and found them misfiled! Now they say that those records came 6 weeks ago but it's still in review which is unusual since it's been 6 weeks in review and 19 weeks from the original claim. So now they will put a “rush” on the review. UMR is evil.

MILWAUKEE, WEST VIRGINIA -- Tried to phone them. They wanted PIN number, which we don't have. Call was automatically transferred to "Operator", whose mailbox was full and we couldn't leave a message. How in God's green earth can you contact these people if you don't have a computer. I have found that all of these 3rd party billing companies are very poorly operated.

SOUTH JERSEY, NEW JERSEY -- Hard to find doctors that take it. People on the phone are unsure what will be covered and what my out of pocket would be. Example: x-ray for my back. Turns out it was covered %100 just with a copay but that's not what they said when I called twice and got 2 diff answers. No one said it would be covered 100%. Could have saved me some worry but at least I didn't pay. Also, doctor offices have tried to call them about copays while I am there but can't get through.

PHILADELPHIA, PENNSYLVANIA -- UMR automatically rejects claims, stating you already have primary coverage elsewhere. They know this to be false, as who would pay 2 health care premiums. It is their default reaction, in order to hold on to their money longer. This type of behavior should be illegal. I now have to take time out of my day and call UMR and swear on a recorded line, I have no other primary insurance coverage. I need to do this every time I take one of my kids or myself to a doctor's appointment.

ST JOSEPH, MISSOURI -- I cannot understand how UMR gets by operating as they do. One hand never knows what another is doing. Every time you call in, a different person. One dept. cannot or claims they cannot view what another dept received. You get transferred and transferred. Promises NOT kept. No one has the correct answers. Some of the workers cannot read a description or choose not to. They appear to stall and use the worse tactics to avoid paying claims.

We send in documents and send them in again and again, UMR says they didn't get them. When I finally insist I have already spoken to another representative who had already admitted they did have it, they "suddenly" find it. I have come right out and told them that I think they do these tactics to keep from paying legitimate claims. I think it is horrific for them to put people through this at a time when you are dealing with illness and accident.

Our daughter was involved in a terrible accident. She is disfigured for life. While we are trying to handle this, we have to fight and fight and argue and argue over each and every aspect of every single claim. What is the point of pre-authorization if the claim is then denied after it is fully approved??? They kept saying we had met our max out of pocket expense for this accident, then make us jump through more and more hoops and then deny the claims anyway.

Our daughter is only 14 and has sank into a deep depression. She is traumatized by the event. While we are dealing with all that, it is upsetting and unfair to have to fight each and every single charge with the insurance company. My husband has served the State of Missouri faithfully for going on 20 years, it is a travesty and I mean a TRAVESTY to have no choice but to use this company! They offer NO dental and NO vision either in our area and never have! It is a TRAVESTY. I pray some insurance commission reads all these complaints and puts a stop to their ways as they put us through pure hell.

SALT LAKE CITY, UTAH -- UMR is a subsidiary of United Healthcare and is contracted with my spouse's employer to administer the company's healthcare plan. Last year we had constant problems with their processing our claims incorrectly. I had to make my own spreadsheet and track all of our bills and payments to ensure we were covered properly, and I spent hours contacting UMR to straighten out their mistakes. Then this year, in addition to a medical provider still owing me over $600 I've yet to get back and it was due to a mistake on the part of UMR, at the very end of the year, for the first time, UMR refused to pay for my covered pap-smear and mammogram.

I had them at the same time of year I normally do to ensure there is a full year between them, and I'd met my $2500 deductible several months before. Yet, they refused and claimed a new rule to our coverage that I am still covered 100% for a pap, mammogram, and well adult exam and labs regardless of whether I've met my deductible, but the well-adult benefit is covered only up to $500 and I'd already used it for the year.

For the first time they stuck the pap and mammogram into the well-adult exam category and said I had to pay because I'd used my $500 allotment for the year. One exam with accompanying blood lab work, a pap, and a mammogram cannot even begin to be covered by only $500, especially in Alaska where medical care costs 30-55% more than other places in the country. What a scam!

In addition, blood work I had done that week, not even related to the pap and exam, they refused to cover for the same reason, but my coverage contract states that I have 100% coverage for everything after I meet my $2500 deductible.

UMR/UHC ended up costing us an extra $3000 out of pocket at the end of the year and didn't even bother to respond to my appeals! I did get one email after I appealed a second time and forwarded the information to my husband's HR office, and in the email they asked me to be patient for a couple of days while they examined my file, and then I never heard from them again. That was last winter and it is now August.

My daughter had a psychiatric emergency - I drove her to the ED of the hospital I work for knowing that insurance would pay better, but there wasn't a psychiatric bed available in our facility. After finding an "in network" facility, the ED staff social worker called a transport service to transfer her to the other facility (85 miles away). Once the claim for the "transport" was processed it processed as out of network hitting a completely separate deductible making the $1,400 bill my responsibility. At no time during the visit in the ED did anyone give me an option on how to get my daughter from hospital A to hospital B.

After finding this out I looked up the covered ambulance companies, of the 3 for the entire state none of the phone numbers worked after hours. 1 of the numbers never worked, 1 company didn't service my part of the state, the 3rd was considerably cheaper which brings up a whole other issue of collusion by my employer, the insurance company and the ambulance service.

How could they not know that the insurance company that they were going with for a 2nd year does not have the only ambulance service that they call in network? Since we are self insured it's a convenient way to pass the cost on to the employees.

SALT LAKE CITY, UTAH -- UMR/United Healthcare denied my coverage for all medical and lab expenses because they claim it was accident related. After I resolved that issue they sent me another denial letter stating it was work related and continue to deny everything including blood work. How is blood work related to an accident/work injury? This was a new diagnosis and not pre-existing which has nothing to do with work or an accident. My co-payments were $40.

UMR will find any reason possible to deny payment. Customer service is terrible and they ask tricky questions and document every word to find more reasons to deny payment. I have spent too much time doing their job by calling UMR, prior insurance companies, doctors, lab, and now worker's comp. I had to file for worker's compensation so I can be denied to prove it is not related to work. Most likely they will find another excuse not to pay. It is stated on their website that they receive “4 million calls annually”. Wow that is a lot of unhappy clients. Perhaps this is why they are not BBB accredited.