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WORST Experience, Most Incompetent Staff Ever
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

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 uhcexchange@uhc.com) 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.

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Horrible Benefits!
StarStarEmpty StarEmpty StarEmpty StarBy -
Rating: 2/51

For as long as both Hubby and I have had full time jobs with benefits, we have almost always elected to use my husband's benefits for medical and dental insurance (mainly because I liked their medical insurance more than mine). We would reevaluate this every November when our respective employers' open enrollment period would begin. It's a system that has worked well for us as the coverage has almost always been comparable between our two workplaces.

Last November, when my job's open enrollment was announced, I asked my husband if he had heard anything from his job about OE. He hadn't so I held off on making any changes until close to the end of my enrollment period when I asked him again about it. He said that they had told him that they wouldn't have any information for a few more weeks but as far as he knew, there hadn't been any talk that year about changing providers (it had been a concern in past years as Blue Cross was trying to jack up the prices as usual).

Assuming that things were going to be status quo, I made no changes to my employee benefits aside from adding ** to my list of dependents for life insurance and vision insurance (I always carried the vision since his job didn't have any at the time). Two weeks after my job's OE period ended, my husband called me at work to tell me that his job was switching both the Medical and Dental benefits to UnitedHealthcare.

Since they had ** footed around and waited until the second week in December to make this announcement, we were SOL. Fortunately all of our physicians were in-network, so that didn't have to change. As far as dental insurance was concerned, I didn't really have any problem with whatever they offered since we had never used the dental benefits no matter who carried them. We just had it as a "just in case."

This spring, we found out that ** has cavities. A lot of them. And they're going to require a lot of work beyond the usual fillings (long story, not going into that). Anyway, we got an estimate from the dentist and I noticed that what was actually listed as the patient's responsibility (about $900 out of the nearly $5K total bill) was much less than what they had told me would be my portion (they told me over the phone that I would be responsible for about $3200 of this bill).

I looked at the benefits sheet for our dental insurance and I saw the line that said "Annual Benefit Maximum" was only $1000. I called UnitedHealthcare (their people are very polite, I'll give them that) and they confirmed that they will only pay about $1000 per year per person. What good is that when you're looking at work like this? It was bad enough that I had to search high and low for a pediatric dentist that was "in network" because the insurance would pay nothing for an out of network dentist, but now the most they'll pay is $1000?

I thought maybe this was par for the course for all dental insurances (they want prevention and early intervention rather than waiting until something like this happens, I'm sure), but then I looked over the benefits that my employer's dental insurance provided (MetLife), their annual max was $3000! There's plenty of blame to go around here. We shouldn't have waited so long to take ** to the dentist. But I blame my husband's job for waiting so long to let their workers know that their benefits would be changing (had we known that they were switching providers, I would have gotten on my insurance even before I knew the specifics).

I blame the HR lady for convincing my husband to take the lower dental insurance that pays nothing for out of network (I wanted the better paying one that would have paid almost same for out of network as in network) even though that wouldn't have helped the benefit max (same for both plans). And I blame UnitedHealthcare for giving us such useless dental insurance for almost the same cost as I would have paid for the better coverage through my employer!

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Service
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

A man named Reuben answered my call and we discussed insurance policies. I had a few questions regarding if I would be covered for certain visits, and, once he found out I would not be, he hung up on me immediately. Very disrespectful and a bad reflection on the company.

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Complete Incompetence
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

My prescription required pre authorization for the new year. My doctor's office was very quick to react with appropriate documentation. Unfortunately United Healthcare was very incompetent. Making multiple calls (more than 4) and being put on hold for an average of at least 12 minutes per call I finally asked the person ** to pull up the pre-authorization approval and verify that it was correctly submitted. It was then determined that United Healthcare had completely messed it up. They had corrected the verbiage of the message but had "forgot" to change the unit of measure.

I was then told to call back in 2 hours because the department that handled pre-authorizations was not open. It was I, as a consumer, asked that they open the pre-authorization to verify that it it was correctly filled out before one of the 5 representatives I talked to finally opened the document and discovered that my script had not been filled in 4 days due to their own incompetence.

My career has been in analysis and problem resolution and the most basic, first step process is to review the document that is causing the problem. Yet, none of the representatives even though about doing this until I, the customer, recommended that they do this. Even after they finally see what they messed up it will take 3 hours for them to correct it. Sadly, before I made the request for them to open the pre-authorization form all of the representatives were submitting a request for review which would have taken anywhere from 2 to 7 days.

I have already been without the prescribed medication for 4 days. I was looking at potentially another 7 days without medication. It is fortunate that this was not a life threatening medication and in need of quick resolution by such an inept company. I am appalled at such ineptness and disgusted with this service. I now have to drive in an ice storm to pick up a script that is 4 days late due to the incompetence of this company.

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Out of Pocket Expense
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

SALT LAKE CITY, UTAH -- My doctor requested an MRI authorization from United Healthcare. United Healthcare denied the procedure. BUT, they paid the vendor when they submitted their bill. When I called United Healthcare about the authorization and if I could pay for the procedure myself. I was told by 2 customer service reps that I could submit the bill and I would be compensated. NOT!!

After 2 months of discussion with various customer service reps (every time I called, I had to give all the particulars of the situation as they could not find the info in their system). Each call took about 60 minutes. At this point, I was told that United Healthcare did not make payments to members but had to pay the vendor. When I asked to speak to a supervisor on one of the calls, I had to ask 4 times and get nasty before they transferred me to a supervisor. I was told I could file a grievance and claim.

I received a letter from United Healthcare that they would "discuss" my displeasure with their customer service dept. LOTS GOOD THAT DID I AM SURE. I was told that even though United Healthcare paperwork said the grievance and claim process took 60 days. A customer service supervisor said it wasn't 60 days BUT 60 BUSINESS DAYS. Quite a difference. We have just asked United Healthcare how we would be compensated for emergency services out of country. I was told that I could submit a claim to United Healthcare and they would pay me.

REALLY - United Healthcare wouldn't compensate me for a procedure in the United States and I am to believe they would compensate me out of country??? I would not recommend United Healthcare to anyone and plan to select another medical provider during the current enrollment period.

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Denial of Prescriptions
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

My daughter has seizures, and the original medicine she was prescribed (which UHC covered) caused bad side effects. She would turn into a different person for the first couple hours after taking her medicine. She was almost manic! As the medicine wore off each day she became depressed and mopey. Her school work was also suffering, and the teachers were asking us if there was a problem. She had previously been a good student and all the teachers loved having her in the class. This was at a low dose of the medicine, as the doctors were ramping her up to the normal dose for a child her size.

After discussing with the neurologist, he then prescribed a new medicine. The new medicine was the same as the old, except it was time release. With the new medicine she has gone back to her old self, and doesn't experience wild mood swings. Unfortunately, UHC will not cover the time release medicine. Because the time release medicine contains the same ingredients as the cheaper first medicine, they will only cover that medicine. We have appealed, with doctors and teachers writing letters to describe the side effects of the first medicine. None of this matters to UHC.

We will continue to pay the $650/month for the time release version. We are lucky enough to be able to afford this. However, I feel for those in the same situation who are being denied and can't afford it. We probably would take her off the medicine completely and risk further seizures if it meant going back to the first medicine. Prior to this happening, UHC denied my cholesterol medication. This medication had previously been allowed by Humana before my company switched providers. My specialist told me I was better taking an over the counter version instead of the medication UHC would cover.

However, he recommended I continue to take the non allowed medication. I did continue to take this medication until we had the issue with my daughter not being covered. At that point paying the monthly amounts for both was not an option, so I have discontinued the cholesterol medication. UHC has a well-earned reputation for not covering medical necessities. They offer lower premiums to companies, and then make up the profits by not covering items the doctors feel are important.

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Patient Received No Help With Incorrect Coding and Billing Problems
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

PITTSBORO, NORTH CAROLINA -- This letter will be copied and placed on the webpages of all companies. My story begins almost a year ago. My husband (a Duke Internal Medicine patient) was scheduled for a follow-up colonoscopy after having multiple polyps found the year before. In the course of the year, my insurance changed and we secured Marketplace insurance with United Health Care. This was premium insurance, very expensive monthly premiums and a $250.00 deductible.

The provider's office did a referral, and here is where the water goes murky. Duke, at the time did not take the type of UNC insurance (compass platinum), so an appointment was made via the providers office with UNC healthcare. My husband called UHC prior to the visit to make sure the paperwork was in order and was told "the procedure was a covered 100%". He had the procedure, and received a bill. Part of the bill was covered but 2900.00 was not. Upon investigation per UNC, the referral was for a screening, not diagnostic and needed a new number.

The provider office said the referral did not need a number and would look into it. UHC said the referral was not correct as well. After multiple phone calls with all three groups and a lot of finger-pointing between companies, the bill was turned over to collections, and UNC will not return phone calls.

A customer service representative from Duke has also looked into the situation and told us today, everyone is blaming someone else. Here is the sad thing, all these companies advertise "patients first, patient centered care" etc. The patient should not be responsible for making sure referrals have a correct number, should not be responsible for making sure codes are correct. He did due diligence to make sure prior to the procedure that it was covered.

The final disservice and disrespect to the patient is making them jump through hoops to find out no one is accountable but him. $2900.00 may not be a lot to some, but it is a lot to us. Add the monthly expense of the insurance premiums, for what should be covered and this is shameful.

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Denial of Shingles Vaccine
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

MINNESOTA -- I have received yet another denial letter from UHC in response to my BBB complaint. They basically rehashed their denial stating it was just an "estimate" and referred me to the "Why Costs May Vary" section. I would understand if they gave me a different amount for my Out of Pocket expense (say $100 & that in actuality it turned out to be $150), but they told me it was 100% covered for a 57 yr. old & that my Out of Pocket amount would be $0.

Had they told me it was only a covered benefit for adults 60 yrs. of age or older or that it would have been 100% covered if I went to the pharmacy to get the shingles vaccine, I would have waited the 3 yrs. (now 2 yrs.) to get the vaccine or gone to my pharmacy where it would have truly been 100% been covered. They gave me the wrong information & will not accept responsibility for their mistake. I was never given the external review from someone outside of UHC even though I had asked for an external review 4 times.

They have basically given me the runaround for 16 months in the hopes that I will give up. They hide behind jargon and twist it to their advantage. Any average person being told "Good Job on Preventive Care" & that the shingles vaccine is 100% covered with $0 Out of Pocket expense would assume that it is a covered benefit. Why would you think otherwise? They are exhibiting "bad faith" all around.

After all this, wouldn't it be a sign of integrity and responsibility just to pay the $210 instead of spending probably hundreds of man hours and dollars to continue to deny the claim. Every correspondence ends with "Your satisfaction is important to us." That is so very far from the truth. If that was true, they would have paid this claim long ago & not ruin my credit by having the claim go to a collection agency.

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United Healthcare Falsifying Patient Medical Records to Deny Medical Services
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

TENNESSEE -- My father needed to have a CT scan per his doctor to make sure that his cancer (has been cancer free since 2000) had not come back. His claim was denied by United Healthcare. The reason stated was "You have cancer in your nose and throat area. You have neck pain. You have a sore throat and pain in the roof of your mouth. Your provider suspects spread of "cancer" to your brain. Your provider asked for a CT scan of your head/brain with and without a dye called contrast."

The letter goes on to explain what a CT scan is and what a MRI is and then states that "cannot be done for medical reasons and you have a brain function problem such as mental confusion, change in vision, slurred speech or a new severe headache."

My father receives this notification and is devastated!!! First of all, he went the doctor with throat and pain in the roof of his mouth. He NEVER complained of headaches, mental confusion, change in vision or slurred speech. He contacted his doctor and the head nurse called back and apologized over and over again since the information that was sent to him was a LIE!!! She confirmed that no one in the doctor's office provided that information to United Healthcare. It appears that someone that works at United Healthcare falsely added this information/LIES to his records so that the medical services requested would be denied.

I am sure this is not the first time that this has happened to customers of United Healthcare. Please do not use United Healthcare for your medical needs because they falsify medical records so they do not have to approved medical services or items. How many others has this happened to? Who can help with this type of fraud?

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UHC Loaded My Med Files With Hoaxes and Impersonated Me.
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

SALT LAKE CITY, UTAH -- United Healthcare mailed me five provider appeal requests I never made. I got four in November 2014 and the last one dated December 5, 2014. First one gave the name of a company and said I made a complaint against this place and said they sent a decision explanation and since it was a duplicate, I couldn't appeal it. What complaint and what duplicate complaint? I've never made one. I faxed UHC in November 2014 and informed them that I did not make a report and for them to correct it. Ignoring tactics they use. They sent me four more of the same.

They were dated November 4, 7, 17 and 25, 2014. UHC indicated they put them in my patient ID files. The last one was December 4, 2014 and dated with an individual's name as provider appeal request I never made. I faxed provider complaint on a horrible P.T. records content that UHC had paid for and last phone contact about that was October 27, 2014. Last fax regarding that was November 2, 2014. I never heard back on the issue about P.T. session.

I got harassed by UHC with nut job fake reports instead, gee I wonder why. Also November 3rd and 4th, I got two phone messages to call UHC about another made up nonexistent report. Saw bad scene, I was done with UHC. No more phone contact and I looked for another insurance. I would have had to have made a report and received a letter back on an appealed decision in a specific time frame long before the P.OT.. complaint to have even exist, which it was not.

They have NO phone connection or faxes or letters on fake reports. I got 2 answer machine calls on December 5 and 8, 2014, from service coordinator UHC, phony, prank sounding message telling me to call her about my requesting multiple therapy times. I never did! I stopped all calls. October 27, 2014 was the last and only sent a few faxes November 2014 for UHC to take reports I did not make out of my files. And I did not of course, pursue initial complaint.

I left UHC in December 2014. They also apparently sent me to physical therapy two other times , pulling a stunt of having my significant medical condition completely left out and had my other med files hoaxed with as medical conditions magically deleted. My only opinion is all of the above. I have all of my medical records however. I've been trying to get all the fake files out and straighten the records out through other places, but not able to yet. I have not gotten five fake file reports I never even made. I do not have anything to do with UHC!

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United Healthcare Rating:
Star Empty star Empty star Empty star Empty star
1.1 out of 5, based on 89 ratings and
136 reviews & complaints.
Contact Information:
United Healthcare
P.O. Box 1459
Minneapolis, MN 55440-1459
866-633-2446 (ph)
www.uhc.com
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