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.
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.
TREASURE COAST, FLORIDA -- As some may or may not be aware United Healthcare terminated 70% of the "Network" providers from their panels. Of course as an insured with UHC notification of this action was not given until after "Open Enrollment" ended thereby locking me in another year with UHC, had this information been available before "Open Enrollment" ended I would not be with UHC anymore however UHC carefully navigated the timing of the terminations of the network physicians so as not to become know till it was too late.
My experience began January 21, 2014 my doctor had ordered "fasting" blood work, I called the lab the day before just to be sure I knew where I was going and confirm the hours, of course there was nothing more than a recording providing the address, directions and hours they are open and informing me there would be no live person to speak to at this location (I should have known right then there was a problem). I arrived at the address provided yet there was no sign, no indication a lab was there upon checking with neighboring properties I was told the lab had closed "months ago".
While standing right there I called UHC and after 25 minutes of checking of course I was told the lab was right there. I mailed them a picture of the empty office and then was provided another location to go to have my fasting blood work done without even an apology, I arrive at the next location provide to me by UHC and again the lab had closed months ago, went through the same scenario with UHC and they sent me to a 3rd location where a lab should have been and yes, believe it or not that location had also closed (Lab Corp was now the ONLY network lab for UHC they did not have to be convenient as we have no other choice.)
The fourth location was the charm. I arrived at the fourth location went to the reception desk to sign in on the sign in sheet for everyone that came in to see I had been there (so much for privacy) and was then told by the receptionist I would need to provide my credit card for them to copy and keep on file for any charges to be put on my credit card if not paid by UHC.
Now understand probably 80% of the time a charge is denied or not paid correctly and they would just put through the charge to my credit card leaving me to fight the battle with UHC and that being the least of the problems leaving your credit card on file for any "authorized" or maybe not even authorized person to use. NOT! I will not leave my credit card with anyone for an in case scenario. It is now 12:30 PM and I am still fasting, the room is spinning and I am feeling very light headed and still no blood work done because without my credit card there will be no blood work done.
I finally left went down the street to our community hospital and had the blood work done and did not provide my credit card to be kept on file and we all know UHC is not going to pay them and I am screwed because UHC only allows Lab Corp as a "network" Lab... what other choice did I have? 3 Locations I was provided to go to by UHC turned out to no longer exist and the fourth wanted to keep a copy of my credit card just in case!
No, the nightmare does not end there! I have been under treatment and had a Mohs surgery (for Basal Cell CA) done April 2013 had a couple of complications so January 2014 I was still under care for skin cancers or lesions that left go can become cancer. In December there was another lesion on my back this time I did not know UHC was terminating 70% of the network providers as of January 1, 2014 and my doctor was one of them. I had an appointment the beginning of January so I mentioned it to the doctor his response was "this doesn't look good" so the biopsy was done immediately, it came back a week later.
Melanoma, and surgery needed to be done. It was schedule to be done Feb but 3 days before the surgery UHC canceled the surgery and called to tell me to find someone in "Network." I am distressed as I already am under treatment for Basal Cell and I must go elsewhere but I moved forward as my doctor said I must get this taken care of. I go to the UHC website, put in my zip code and lo and behold, 51 doctors come up but that was not to be so true.
10 of the doctors are listed as many as 5 times with different addresses, 4 of them are more than an hour each way to get to but none had an available appointment until March 26th and it could not be with a doctor it was with a nurse and she would decide when and if I needed an appointment with the doctor (I am not taking the treatment or non treatment of my Melanoma to a nurse!) No wonder they advertise on TV constantly any quality competent physician does not need to advertise on TV for patients! They want to bill my insurance the same amount for a nurse as a physician they are not on the same level as an MD, sorry!
After much back and forth with UHC they found me an appointment with another doctor, I waited patiently for my appointment day, arrived with all my records in hand anxious to finally be seeing a doctor and moving forward with the treatment for the melanoma... NO that did not happen! Though United Healthcare made the appointment and insist this physician was in "network" his office insisted he did not accept my UHC even after speaking with UHC on the phone at length I was left with no treating physician and a melanoma on my back that can be spreading or even moving to other organs and no "Network" physician to see and treat me!
I spent more than 3 hours on the phone again yesterday with UHC and still do not have an appointment for what can be a deadly form of cancer, I am 58 years old there is no excuse, no justification for this to be happening. United Healthcare decided to terminated 70% of the "Network" providers because the fewer providers, the fewer appointments, the fewer appointments, the fewer procedures or surgeries can be done and guess what that all converts to... United Healthcare pays less money and makes larger profits without regard for the health and welfare of those of us locked into UHC until 2015!! This should be criminal.
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!!!
PHOENIX, ARIZONA -- Worst health insurance company ever. They force me to live a horrible life of pain and agony simply because they won't approve the artificial disc replacement surgery my team of specialists say I need. I live a life of narcotic pain killers, nerve ablations, lots of painful and damaging epidurals and they continually deny me. They should not have a choice or say in what quality of life I am forced to live. My family suffers from my situation. They have denied the surgery I need to restore my life, for 2 years now. I guess I need to sue them in federal court. Shame on you UHC.
MINNEAPOLIS, MINNESOTA -- To start this, I have an HMO plan. So I expect to jump through a few hoops to get coverage on what I need. This being said, this has been the most backwards healthcare I've experienced. Expect to call their customer service department every other day to make sure your procedure approval isn't dropped or on hold. I was told they have received my lab results and the approval process is pending and it will take 10 days to process only to call back the next week and learn that those lab results are not in their system and that they have not received them at all.
The nurses from my healthcare provider have said they've never had any other issues with this procedure from any other insurance provider. This is the third terrible experience I've had with them in a few short months. I cannot put any more emphasis on how mismanaged and unorganized United Healthcare is. I will be moving to my wife's insurance no matter how expensive it is.
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.