DAVIDSON, NORTH CAROLINA -- I needed to get Physical Therapy done and I called a Facility close to me that confirmed that they are in network for my insurance. I also checked and confirmed that they were in network for UMR/UnitedHealthcare website. In addition, I also called Grand Rounds (3rd Party that helps with insurance questions for my employer) and they also confirmed that this facility was in network. Once the claim was filed they told me that I went to an out of network provider. I checked online and my facility still shows as in network.
If they are out of network then UMR/UNC is committing a fraud by telling its customers to go to an in network provider and then processing the claim as an out of network provider. Other than this situation, I've had some sort of an issue with every claim that was filed. United HealthCare used to be good but when UMR took over I've had all these issues and if my employer gives me a choice I would never sign up for them again. I'll be definitely giving this feedback to my employer as well and hope that they can offer the employees better options in the future. Attached is a screenshot showing that my facility is in network.
CALIFORNIA -- Prior to turning 65 I started to research providers to use when I would be eligible for Medicare. A friend forewarned me that getting an appointment would be a very frustrating experience - but I opted to go with United Healthcare - you know the Licensed Insurance Sales Agent seemed to assure me that I was getting what I was requesting. It's a shame. He really didn't care - he just wanted to make a sale - at least this is what I feel.
I agreed to the plan which included: medical group, vision, dental and fitness. The first time I go for a vision exam - well the vision insurance doesn't cover this or cover that, so I walked out. Then I was reviewing the dentists in the network - well I am very fearful of going to the dentist (aren't most of us) and I was sent a card for a dentist whom I didn't even pick; I'll stick with the dentist I am used to and pay out of pocket.
I need two dental extractions and the oral surgeon (whom I have to pay for) stated that anyone over 50 needs a physical examination by an MD. I thought ok I can do this so I telephone the medical group. Well the doctor that the Licensed Insurance Sales Agent recommended to me (as I wanted a female) she is now a Medical Director and basically she really is too busy to see patients. Wow - so I opt for a PA. The call center employees whom I have spoken to have been very accommodating but come to find out after five or six individuals a PA cannot sign off on a physical examination. So I want to get in to see an MD as I am worried about the temporary crown falling off and the other tooth which is exposed becoming abscessed. Well, currently the wait for "new patients" is 6-8 weeks out; really.
After all of that, I call for an advocate from United Healthcare and I get someone just to be informed that he couldn't help me and I had to go through Customer Service. DO NOT PICK UNITED HEALTHCARE - It seems to me all the Licensed Insurance Sales Agents care about is fattening their pocketbook. I am switching and just hope I don't become ill because of the two teeth which need extracted becoming infected or cause me more problems.
After 3 weeks of battling an ear infection, I came up with an allergic reaction to the antibiotics. Unfortunately, it was 3:30am on Christmas morning when I finally decided to go to the 24 hour urgent care - only to find out it was closed. So I called the nurse hotline at United Healthcare. She was very sympathetic and gave me info about the virtual visits that United offered. I signed up and paid for my virtual visit at 4:09am. They confirmed my visit at 4:15am and gave an approximate wait time of 10 minutes.
By 4:43a, I contacted them again. The representative said I was in cue and 2 other doctors will try to reach me. I told him that I received an email saying that they tried to reach me but could not. We needed to problem solve because my computer works WELL and I was in their "waiting room" the entire time. He said that he is unable to help me because he cannot connect with that department. He said just wait for the other 2 doctors to try to reach me and reminded me that he is unable to troubleshoot. Long story short, this happened 2 other times. It is now 6:51am. United Health cancelled my virtual visit and my ear still hurts. I will definitely lobby my employer not to use them anymore!
COLORADO SPRINGS, COLORADO -- Their billing department called me when I was in active labor in my hospital room for maybe an hour to ask if I had a vaginal delivery or C-section. Seems like their money is more important than what I was going through at the time. I was in a lot of pain and the phone kept ringing. I would not recommend this health insurance company; I would have a different insurance company if my employer offered others. I felt really disregarded by this action. I should have been able to concentrate on my labor and baby without worrying about anything else. This matter could have been handled at a later date. On top of that, it was a foreign lady whom I could barely understand.
WINSTON SALEM/SOUTHSIDE, NORTH CAROLINA -- After two years I've finally had enough.... My doctor was not the problem she (Dr. **) was the best it is the sorry untrained staff!!! They don't answer the phones or return calls.... My pharmacy sends faxs and calls also with no reply (They told me it's worst theyve ever dealt with. It's like there's nobody there!!!!) Many a time the only way I got my Meds or to make an appointment was to make a personal visit!!! And every time I seen my Doctor I would express that they needed to do something about it, and she told me she brings it up at every meeting to no avail. If you like being treated like trash this is the place for you!!!
CHARLOTTE, NORTH CAROLINA -- First, let me start with the fact that the customer service group was always very friendly and understanding. This was not the problem. The problem is that I had shoulder surgery in June 2018. It is currently March of 2019 and I am still fighting with them to pay bills from June/July of last year. As a matter of fact, the anesthesiologist was just paid last week!! I have these bills hitting my credit report now. I get a different explanation from each person I speak with, as to why the bills haven't been paid yet. They always blame the provider. They also refuse to let me speak with their management.
The doctor was very clear with them before the surgery that more PT would be required than what my plan covers. They agreed. In the end, my approved PT visits ran out. We knew this would happen and the provider had to send in for prior authorization. I received an approval letter for 12 extra visits. I went to three of the visits. My provider then tells me the claims are being denied. I called UHC immediately. They said, "Oh we approved for you to go to more visits, but we never did not say that we would pay for them". I lost it.
I explained that I didn't need their approval to go anywhere! I only need their approval to pay the claim. It has been nonsense from day one. I am also a Type 1 diabetic. It is a constant fight to get the supplies that are required for me to live. I ended up having to pay for these visits out of pocket. I just feel that it is criminal! There are many people who have no idea how to fight these things and they just pay bills as they come in. If I had paid for what they said I should have, it would have been close to $10,000 after I had already met my out of pocket maximum of $4,000. How many people are paying for medical expenses that they shouldn't??? And why on earth should they be able to tell my doctor what he is allowed to prescribe???
I have been handling my own medical issues and insurance for more than 20 years. I am a T1D as I stated before. My son sees a couple of specialist as well. I have had several different group insurance plans with BCBS, UHC, Aetna, and Cigna. I have NEVER experienced such a complete mess in my life, as I have with UHC. According to my Orthopedist, they even cringe when they see that a patient has UHC coverage, if they need anything out of the scope of a standard visit. It is such a sad thing. Thank you for allowing me to vent.
ARIZONA -- Prior to retirement I was bombarded weekly by printed material by AARP advertising United Health Care. Since I knew I was moving from TX to AZ at the end of 2015 I signed up with UHC in October so I could start getting coverage from Jan 2016 when I started living in AZ. I contacted UHC and they gave me the name of a GP physician I could see. I saw that person for a diabetic checkup Jan 18, 2016 and was told they did not accept UHC insurance after UHC indicated he did. I incurred a bill of $247.
Month after month I contacted UHC trying to get them to pay the bill only to learn I had NO coverage since Jan 1 due to a mistake the person at UHC made when they completed my enrollment. It was after April before they recognized their error and made my coverage retroactive. In the meantime I settled with Honor Health Scottsdale for $197 and paid it myself given verbal assurances from UHC they would pay.
It is now July 10, 2017 and still no payment! In Nov 2017 my coverage was made retroactive to Jan 1, 2017 and I go back and forth with customer service. First I had to fill out a written claim and send it to one P.O. Box in Utah. I did that--no response. Then someone else at UHC said I had to sent it to a P.O. Box in CA. I did that too--no response and also no way to contact anyone by phone at their claims office. Then I was told I had to contact LifePrint since they paid out claims. I did that and they said, no, they don't do that and I had to contact UHC again. I did that and got a new case ID.
Then they said it was sent to the wrong group. I called again and they said it went to the correct medical group. Now I hear that they need more information. This is totally insane. The company is so big and nobody has the power to resolve claims quickly. After 18 months this has become almost laughable if it was not sad. AARP should drop UHC completely. I am 70 years old and do not know if I will outlive this claim at the rate things are going!
MARKET PLACE, FLORIDA -- WORST, WORST, WORST experience ever! Here's my experience... (Personal information has been changed for my privacy). 2012 - Signed up for individual insurance for "Suzy " (female) with United Healthcare Golden Rule. March 2015 - Signed up for individual insurance for "Suzy " (female) with United Healthcare MarketPlace. - March 2015 - Marketplace plan was started, and month 1 paid. ID **. March 31, 2015 - Marketplace plan was terminated without communication to either Suzy or Stewart. March 2015 - No payment made to United Healthcare Golden Rule.
May 2015 - Suzy realized she never received an insurance card from the MarketPlace and could not log in to their website. May 2015 - Stewart (Insurance Agent) and I ("Suzy Anne " (female)) called United Healthcare MarketPlace regarding plan established in March. Response was that the plan never went through, and a new application was filled out over the phone. New application used the wrong name (Anne as the first name, as the surname, no mention of Suzy) and indicated insured was a male. Suzy paid $713.72 to cover the balance from April and May. ID **.
May 2015 - United Healthcare mailed Suzy 2 letters regarding outstanding balance of $38.62 and a period of 10 days to pay the balance. Suzy was out of the country and did not receive either letter. No communication was made via email or telephone to either Suzy or Stewart regarding payment issue or coverage termination. July 20, 2015 - Physician office calls Suzy regarding insurance had been terminated. ID **.
July 20, 2015 - Suzy and Stewart call United Healthcare, call was disconnected. Suzy called United Healthcare back and spoke with a customer service. She was advised her insurance had been terminated for lack of payment. Bank statements indicate a check for $224.11 was mailed to United Healthcare each month, yet according to the United Healthcare representative, none of those payments were attributed to Suzy 's account. According to the bank, they were all cashed. Suzy was advised to send an email and explain the situation. An email was sent (to firstname.lastname@example.org) and Stewart was carbon copied.
July 21, 2015 - Email from United Healthcare was received by Stewart that read "We will make the exception to reinstate without lapse with the additional $38.62 and the June payment of $262.73 for a total of $301.35. The insured can call and pay with a cc payment today or they can send a payment to us to be received by the close of business on 7/23/15, after that date we will not be able to reinstate without lapse."
July 21, 2015 - Suzy called United Healthcare, paid $301.35 and was advised her account would be reinstated. This reinstated her Golden Rule account from 2012 (ID **), not her most recent MarketPlace account. Suzy was transferred to the MarketPlace, however after speaking with someone and waiting on hold for more than 30 minutes, the call was disconnected. Prior to being disconnected, Suzy was advised that she paid $713.72 in May, and her account had been terminated at the end of May.
July 22, 2015 - Suzy called United Healthcare Marketplace to get reinstated. She was advised that her account (ID **) had been terminated in March. The representative advised a new application would need to be filled out. They found Suzy's name was written as Anne and she was identified as a Male. The call was disconnected before the application could be completed.
July 22, 2015 - Suzy called United Healthcare Marketplace to get reinstated. She was informed that there was nothing she could do as her insurance had been terminated. Call transferred to Tier 2, who sent a request to United Healthcare Case Management to reinstate insured. Suzy was advised the process could take 1 - 2 months. No record of May's payment or Golden Rule account was found. July 22, 2015 - Suzy called United Healthcare Golden Rule to confirm insurance coverage secured the day before (July 21, 2015). Her ID (**) could not be found in the system.
July 24, 2015 - Suzy and Stewart called United Healthcare MarketPlace to discuss coverage. Their system did not reflect calls from earlier in the week, nor did it correct the name "Suzy Anne" and "Anne." Service representative Lance advised call would be elevated to someone that could problem solve and worked on odd situations; United Healthcare MarketPlace should be in touch with Suzy in 5 - 7 business days with a resolution.
July 28, 2015 - Case management called and left a voice mail. Name (first name only) was not understandable. Did not leave a case number. Call was to informed me they had my case and would be working on it. July 27, 2015 at 6:20pm. Called number left on the voice mail (877-887-0441), no notes regarding case management, case manager or case number. Called number that called me (**), call was disconnected.
July 31, 2015 - The MarketPlace called to inform me my application has been updated. Marketplace has updated my application. Sent the application and a request for reinstatement to the UHC. Have to work with UHC to get reinstated. Has no information about payments, old policy ID number. At this point I have to work with the plan (aka UHC). Name and sex have been corrected. No idea who at UHC I need to talk with. Advised her that my policy got messed up because the Golden Rule and MarketPlace systems didn't catch the error in my application.
She asked why not, and I said it was because the systems don't communicate and neither do the people. She said I would need to work with the insurance plan. I asked who that was and she said the plan. After asking for clarification again, she said it was UHC. I asked which department at UHC I would need to talk with since if I called then and said, I need to talk with the Plan, they would think I sprouted a second head. She said she didn't know, she wasn't part of their company and doesn't know their departments. She doesn't communicate with them.
July 31, 2015 - United Healthcare called. Received a file from the MarketPlace on 7/15 showing termination should have been 3/31. As of today, UHC has not received anything from the Marketplace. If the Marketplace sent something, it will take about 30 days to process. July 31, 2015 - A letter from Golden Rule and check came in the mail today. The letter states that I am paid through July 31, 2015 and in fact overpaid by $224.11. The check is for $224.11.
Here are the issues: This payment was made through the website that we set up access to while on the phone with the Marketplace in May 2015. This payment was applied to my old Golden Rule account from 2012. I was dropped from the Golden Rule account in May for non-payment. The Marketplace won't show record of this payment. I also received a letter from the Marketplace that says I am eligible to re-enroll in January. This is the first communication I have received from the Marketplace.
March 2015 through current - Suzy never received any communication, a new card or an invoice from United Healthcare Marketplace. March 2015 through recent - United Healthcare Golden Rule has been charging Suzy for an old plan, collecting payments and not attributing them to her account.
Sent them: Bank payments for United Healthcare Golden Rule. May payment for United Healthcare MarketPlace
American Express payment for $301.35 for United Healthcare Golden Rule, made July 21, 2015. Total paid to United Healthcare 2015. Jan: $224.11. Feb: $224.11. March:. April: $224.11. May: $224.11 and $713.72. June: $224.11. July: $224.11 and $301.35. Total: $2,359.73. Marketplace premium: $356.56. Owed to United Healthcare for = $-35.85.
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?
SALT LAKE CITY, UTAH -- I am so surprised to see bad reviews! I had this insurance in 2014 through my husband's employer and ended up needing a hysterectomy in December 2014. My husband's employer had already decided to switch insurance companies in Jan 2015, so I was in a time crunch.
I went on Dec 8th for pre-op evaluation, and my surgery was scheduled for Dec 18th. Unfortunately I found on from the hospital on Dec 17th that the insurance had not yet approved the surgery, because pre-approval had just been submitted by the doctor's office that morning, the day before my surgery.
I called the insurance company in tears to get this surgery done, as I was in pain, and I was told she would do everything possible to get it taken care of. I also stupidly disclosed that we would be changing insurance companies in a couple weeks and I didn't know what the coverage would be and I had already met my out-of-pocket annual maximum - a perfect reason for them to delay approval to not have to cover.
Imagine my surprise to get a call at almost 8:30 pm (well after closing time) to tell me it was all taken care of, I could have my surgery the next morning. Surgery was done, bills were paid, no problems. A few months later the anesthesiologist was billing me, saying my insurance didn't pay them. I looked at the EOBs, which said I owed them $0 due to network discounts, so I called and told the provider this. They said OK, no problem.
A few months later (after my coverage ended) I got a call from the anesthesiologist again saying I owe, and that they are not in network with my insurance. I called UMR and they got on 3-way call with me and the provider and told them they are in network. The anesthesiologist office said "I don't care. We are billing it."
True to their word they sent me to a collection agency. I told them what happened (Note this was almost a year later, long after coverage was terminated with this plan). I called UMR and they send documentation to the provider showing their in-network status with a copy of the contract. The collection agency continued to call and I continued to explain to them and they told me to call the provider, which I did, and they said they would look into it, which they didn't.
Fast forward to today, March 2016, 15 months after my procedure and the termination of my UMR plan - the collection agency said I need to send EOBs to show I don't owe the balance by the end of the day or my credit is going to take the hit. I called UMR with no ID, no active plan, and no benefit to them whatsoever and spoke with Natalie, a super sweet woman who looked up all EOBs for anesthesia (as they did not bill under their business name, but under a provider whose name the provider couldn't tell me), and she faxed the EOB immediately and waited on the phone to make sure I got it. I faxed it to the collection agency; game over - I win.
UMR reps were always understanding, helpful, accommodating and expedient. I know they say people are more likely to leave a bad review than a good one, but I believe this company definitely deserves credit for the assistance they provided me, and continue to provide long after my coverage was ended. I would recommend them to anyone looking for good customer service.