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United HealthCare Services Complaints 477

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United HealthCare Services denial of benefits

In short it has been a nigtmare. Customer service is horrible. I have extended coverage through Cobra now since I was laid off on June 1 and my benefits technically ended June 15th, 2010. I am waiting to have a gastrectomy and pre approval was submitted 6-9-2010 prior to benefits ending. United Healthcare via Sedgwick CMS is now denying it based on coverage termination, however they received the submission from my doctor prior to benefits endidng and the letter clearly states this, the letter dated June 24, 2010 from them which denies the surgery based on criteria, is also wrong. This is their response...
"Rationale: Based on the information provided, the member does not meet all the extensive and rigourous Plan documentation criteria for coverage of obesity surgery(BMI.35 with significant comorbid obesity-related health condition, for at least 2 years; documented ongoing active participation in comprehensive weight loss program for 6 months within the past 2 years), and the proposed bariartric surgery is not covered."

The administrator for United Healthcare and my employer Sedgwick CMS sent me an e mail with the coverage information and criteria, this is not what it states. With my doctor we made sure all the criteria was met.
Aetna Insurance has approved the surgery and has the same criteria, I had had the same situation with Aetna attached is a copy of their intital denial and also the approval after documents were sent. What is difference with Aetna they were polite answered all my questions and expedited it immediaitely. United Health care continues to give it's people the run around.
They reviewed it and sent a denial within the coverage period. I have extended benefits via Cobra and they continue to say that they will not reconsider the surgery or an appeal because I am not covered and until the monies show up in their account they will not consider reviewing it. BAD FAITH if you ask me.
I have spent 2.5 hours o the phone today going from division to division, they place me a hold AND THEN DO BLIND TRANSFERS! Please help. This again wa s reviewed within the policy period and the appeals should be considered as such other than that United would be acting in bad faith. I have attached copies of everything

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Compassion
Seattle, US
Jan 07, 2011 6:01 am EST

That was a rude and unecessary judgmental comment. You better hope and pray that you never face a medical obstacle---eventually everyone gets a taste of their own medicine---you might want to sweeten yours up a bit sweetie

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sherri713
Harrisburg, US
Jul 13, 2010 2:47 pm EDT
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I'm so sorry you are having so much trouble with you insurance company. I have been fighting with my insurance caompany for several months. It seems there is little we can do. Its like we are at their mercy. But just wanted you know I sympathize and hope the best for you.

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3:19 pm EDT
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United HealthCare Services customer service nightmare

My complaint is against United Healthcare and how they deal with subscribers. I have logged over 5 hrs of telephone communication with United Healthcare in a 2.5 week period (from 4/20-5/6). I have been misinformed about information in my account and am enraged with UHC's Care Coordination Department, Appeals Department, and Benefits and Eligibility department.

United Healthcare needs to improve both its voice networking system, making it easier to navigate from one department to the next without having to repeat all of the same initial subscriber information, and it needs to improve the quality of their customer service agents, both in terms of their communication skills and knowledge of UHC's system.

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fedupindfw
dallas, US
Sep 01, 2010 9:42 pm EDT
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I absolutely agree. UHC's customer Service is non-existent. I received a bill from my former physician for services performed July 2007 through November 2007-yes THREE years ago. I spent 3 hrs on the phone. I am sure UHC's main customer service site is in India. I was transferred back and forth at least 6 times. I was transferred to an automated survey twice, and once when I asked to speak with a manager, the customer service rep hung up on me. My former physician has re-submitted the claims twice and each time UHC denies coverage: "Insurance Terminated". Well, DUH! No kidding I am not covered by UHC now, but for the entire year of 2007 I was covered. I wrote UHC a letter. I did hear back but they state they have "No record of this claim."Then the form letter tells me to visit www.myuhc.com to view my claims and EOB's. Well I cannot access anything because I am now with Aetna .The stupid letter even tells me to "call customer care on the back of my member ID card..." and to mail a bunch of required info to, "The address on your member ID card."

They infuriate me so much. I am not paying another dime...other than postage to keep sending documentation that I was covered.
I'm not to happy with the physician either. Why wait THREE damn years to refile a claim? I do have one of the EOB's with a claim number stating that the physician was paid. At the very least I hope to be off the hook for $140 of the $345 they are demanding.

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United HealthCare Services over charges

With the high cost of proscriptions we are asked to us mail order to save money and help with the cost. I have just had my first mail order done. and it has cost me over 2 -1/2 the cost of getting filled at walgreens or any place with a 30 days. It would have cost me 35 dollars a month for my sons medication that would cost me 105.00 dollars to buy at walgreens for 3 months. Having the mail order filled it cost me 240.00 dollars and when I call to find out why they tell me they just fill the order and take money. never to ask if they can use anything to help save money I give them my phone number which they could have called to ask any questions. I think that this is a very big mistake and they should be held responable for the over charges. Without first contacting at least for the first orders. That way there would not be any bad surprise when the proscriptions come in with a bigger bill. I would like to see something done to protect everone from this. All first time mail order should be informed what it is going to cost before the proscriptions are filled. the same way walgreen or any other company would fill proscriptions.

thank you
Edward Snelling Jr
Phone [protected]

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Constant clerical errors not forthcoming about important medical coverage information dishonest about receiving and sending important medical documents and appeals constant evasive tactics to avoid paying rightful claims

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United HealthCare Services lying and denying

Our child was admitted to an inpatient intensive care unit. United Healthcare has weekly "doc-2-doc" calls with the treating physician. We were just told by UH told that our doctor recommended immediate release and that further coverage would be denied. Amazingly, this is at best a misrepresentation of the conversation. At worst, an outright fabrication of the truth. Almost needless to say, we are fighting to ensure our childs healthy recovery, but are woefully inexperienced in the insurance process and understand that we are up against this country's most notorious health care provider, who has a national reputation for mistreating its customers. Since we were not a party to the conversation we can't say for certain what was said by our child's doctor, but are trying to insert ourselves into the process to make certain this does not happen again. I have owned my own company for many years, but fortunately have not ever placed my group coverage with UH. Thank ###ing god for that sliver of good luck. Too bad Congress - Democrats and Republicans - can't muster the intestinal fortitude to correct this problem. We're on our own out here.

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United HealthCare Services non payment to service provider

Generates TONS of red tape to collect payment for services rendered, COVERED by patients plan. One excuse after the other, the patient doesn't have benefits, once you spend an hour on the phone. Miracle, they have benefits, the claim should have been paid, then they send it back for reconsideration. Which then responds with a request for more paperwork. (They had paid the claims in prior years, after several phone calls years, only delaying payment for MONTHS.) Now they're two and have years without payment. We've had to TERMINATE patient. And now the PATIENT is responsible for the bill. So when you get angry with health care providers, now you know where the problem lies.

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3:19 pm EST
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United HealthCare Services termination of coverage

I just started getting long term disability and no one told me that I had to pay for my insurance out of pocket, the month of november I only recieved 400.00 dollars toward my long term disability. I am submitting a request a review Barbara Mackey 2419 school st Rockford Il [protected]

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Reviewer17369
Aug 26, 2015 5:29 pm EDT

Refused to cover my health related, not cosmetic, vericose veins, and ultrasound for breast cancer prevention

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johnnyb44
Hammond, US
Mar 19, 2010 12:17 am EDT

well they are good for nothing anyhow, in fact I'm getting ready to call Obama. I had a brain anneurysm burst and it cost $880, 000. They paid nothing. so, drop them. you are better of filing for indingent funds and hoping for charity, in which I did and they saved my life regardless of insurance. Drop them, I am just beginning my crusade against them.

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3:59 pm EST
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United HealthCare Services will not pay claim in alloted time

I called the office of the Georgia Insurance Commissioner to find out why United Health Care was sued for $750, 000 by the state of Georgia. The investigator told me it was because they would not pay for claims in the time period specified by law. He also told me this is the second time Georgia has had to sue the company. United Health Care was sued for the same thing about a year ago for $2.8 million. This is the company AARP is advertising on TV as the company senior citizens should get for their supplementary to Medicare. I am glad I called my office of Insurance Commissioner, maybe you should also before you buy insurance.

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United HealthCare Services medco denial of service

Since becoming a member of United Healthcare about 31/2 months, I have been denied, at least 5 times, medication that my previous Insurer has paid for, without question. They farm out prescription services to Medco. I have followed their procedures, and still they make me change to a cheaper medication, even though my doctor thinks he is prescribing what is best for me. Their job is to "be the judge" of what you get. If your plan does not cover what your doctor thinks is best for you, you and your doctor have to follow an appeal process. They will spend hours and hours on the phone, just to keep a patient from getting something they don't want to pay for. They will send you an authorization, or an appeal form, but by this time, you have already left your doctor's office, and are waiting at your pharmacy, then gone home. Sometimes you can get your meds, and sometimes you just have to deal with it. If they are so worried about their bottom line, they should be cutting better deals with the pharmaceuticals, but they already do that, don’t' they? Or maybe raise their rates. Oh, yes, they have done that too. They even want me use a pill cutter to cut my one med in half, just so they don't have to buy both dosages. Since most of the competing healthcare insurance companies have been gobbled up by Aetna, United and others, their simply is not as much choice for employers to shop around for quality, affordable plans for their employees. Period. If members of the U.S. Congress had to deal with a fraction of this hassle, they would be changing the law in a New York minute! Keeping people out of the hospitals by the use of drugs already is a proven approach for everyone. Why keep that medication from us, so that we get sicker, and risk an even bigger claim? The answer is that they know we have no one in our corner, as they do in Washington. I urge people with issues of abuse of power, and denial of service to let their thoughts be known, or it will never change. I also urge anyone who is trying to buy health care insurance, to find out all the details you can before you sign up, because after that, it's too late...

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petromad
Eloy, US
Dec 05, 2009 12:22 am EST

United Health Care tried to get me fired today. I called a UHC rep to dispute a claim and shortly after the phone conversation they called my company's HR and complained about the way I behaved over the phone. The HR head and my supervisor had a meetin and I was told that UHC only wanted me to correspond with them electronically. Is UHC some sort of health care mafia? I hope the world sees this.

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United HealthCare Services health insurance

As a provider of vision care, this is the worst customer service I have had to deal with, upon calling multiple times and being transfered to multiple locations, incl. India, where they can hardley speak english, I had to finally tell the patient I can not get through to claims and he is just going to have to pay my company direct. Lost in the healthcare mayham. I feel so sad for these siniors who get taken advantage of.

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Marcia Hughes
Rialto, US
May 30, 2012 9:34 am EDT

My husband has had 3 Strokes, 1 on the Left and 2 on the right. His balance has been greatly affected and falls multiple times per week. We asked for a simple powered scooter to improve his SAFETY and quality of life, not an Escalde or Hoveround, wouldn't you think this would be cost effective? Last fall cost $11, 000.00 plus 1400.00 for 911. He tore a vessle below left kidney and had to remian in ER until bleeding stablized, 11hours. He has had to have multiple x-rays as a result of the falls. I hate to think of a fractured hip or worse as that would mean surgery and rehab, a lengthy recovery. His Doctor agrees he should have this simple scooter and has done all that he can.
Secure Horizons could be so much better without their gate keeper Primecare. Primecare specializes in denial of everything, their goal is to save money for Secure Horizons this is why the insurance companies hire gate keepers. If you write an appeal letter to Prime care and your Dr. calls them then they will send someone to your home to evaluate the situation, this person brings no equipment, supplies or knowledge of what he is requried to do. I had to read the Drs order to the Physical Therapist. Prime Care case manager "MG" Will not call you, you must call her so that she can state due to all the testing (really?) that was done we are denying your request. Ha Ha I have wriiten a letter of appeal to Secure Horizons and directly to Medicare, hopefully this can be resolved soon.

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Calif Thomas
Silverado, US
Nov 01, 2009 1:58 pm EST

Secure Horizons (AARP), who is impossible to get "to" as in past the phone answering person, must scrub this site -- there had to have been more complaints. They canceled my insurance claiming I moved (which I did not and could not convince them of such.) I spend literaly hours that I logged and finally gave up! Meanwhile, no Medicare part D, had to pay 20% of a first-time ever since having babies hospitalization (is this really why they cancelled me?) and so on and so forth. They are an evil organization who are patently dishonest -- and unreachable. DON'T SIGN UP WITH THEM NO MATTER HOW CHEAP THEY ARE OR WHAT THEY PROMISE!

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United HealthCare Services non-payment of medical claims

United Healthcare fails to approve payment of medical claims. Same claim has been submitted with all necessary paperwork and forms numerous times. These claim involves a second insurance plan that is considered primary. EOB's from primary have been submitted, but everytime they conveniently misplace one of the documents needed to complete the claim. They will not accept a fax while I am on the line with them so that it can be associated correctly. I am requested to resubmit the claim with all documents again, only to have United Health misplace some other document. It's a never ending thing.

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United HealthCare Services medical claims

I have a son who receives "covered" Occupational Therapy and Speech Therapy weekly, and for the last entire year, United Healthcare has HABITUALLY processed the claims incorrectly and/or unbelievably slowly.

The 1-800 agents are rude, incompetent, and the "claims appeal" process is a joke. I literally call them on a weekly basis and get no clear direction on how they want the bills to come/how I should file. For my company, we only have a year to appeal claims and United just runs the clock out on you.

Additionally, the pharmacy coverage is laughable. Btw, I work for a mid-size company (approx 26k employees).

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Garylmccann
US
Mar 16, 2016 1:22 pm EDT
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Medical plan # [protected]
Group # 902732
Medical ID# [protected]
There data base is so inaccurate that it is gross negligence on United Healthcare part. MY primary care physician has been trying for several days to get me an appointment but she has not found a single doctor listed in there data bast that is #1 open and actually in business. #3 someone will answer the phone. #3 will take my insurance. I am left in pain because United Health care is taking my money and not providing the services I am paying for.

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denver101
jackson, US
Nov 30, 2010 2:22 pm EST

I thought my old Oxford coverage was bad because they kept upping the cost of pharmacy copays but I paid out of pocket for an emergency surgery which is covered by UHC for out of network doctors and I have had to send the claims form in twice and the claim is still "in process" three month from the operation. I lucked out with getting native English speakers but they basically had no idea what they were talking about. One operator told me that UHC would notify my doctor via snail mail to resubmit a claim form with x-ray. Point 1, UHC never notified my doctor and thank god I called them to make sure or the resubmission would never have occurred. Point 2, why would anyone send a letter instead of email unless they wanted to hold on to their cash flow as long as possible. Insurance companies suck and if my company did not automatically enroll us, I would rather risk paying for the sum total of my medical bills than give a single penny to these vultures of society.

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hookem
US
Sep 12, 2010 12:17 am EDT

wrye1226:

What an idiot. Where did you take the discussion to make a tirade of an Indian call center? Jealous of your smarter Indian physician counterparts?

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agardner
Lees Summit, US
Sep 03, 2010 7:07 pm EDT
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I totally agree.. the claims and appeals process is a complete joke. I have been denied three times for emergency surgery that already took place when we were out of town and "out of network." I have gotten so much conflicting information from UHC, wasting hours and hours on the phone. And yet, they denied the claim again today.

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wrye1226
Dallas, US
Feb 17, 2010 1:29 pm EST

I have the same problem...We are an anesthesia group in Texas that is NOT in network with UHC. When an insurance company pays out of network we will call them and most every other insurance companywill reprocess our claims in-network (RAPS) if the facility and/or surgeon is in their network because the patient has no choice as to sho to use for anesthesia. With UHC, I always get a foreign person that I can hardly understand and they cannot understand what I am saying to them. Sometimes they will tell me the claim will be reprocessed and they give me a reference number and say to allow 15 busniess days...I'll call back in about a month and I am told it was not processed right and they will send it back through to be reprocessed and tell me to use the same reference number when I call back to check status. I have to keep doing this over and over on the same patients. Every once in a while I wil get an American and when I do...I am so thankful. WHY DOES UNITED HEALTHCARE PUT THEIR COSTOMERS THROUGH THIS? I have asked an American rep before why does a foreign person always answer and I was told they were trying to change things to where they are getting rid of the people in India. I just want to hang up when those people answer the phone and then they tell me their name...it's always an American name like...John, Sue, Jack...etc... we know that's not their real name...I am just so thankful I don't have United Healthcare as my Insurance and feel sorry for all those who do. They waste so much of my time!

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Anita89
US
Jul 26, 2017 5:36 pm EDT
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Replying to comment of wrye1226

I have the same issue with UHC!
I briefly explain what services we render and we are out of network, and it like I'm talking to little kids because they don't understand what RAPS is! But I would like to ask you, who and how are out of network pricing based when the RAPS clause apply to the claim?

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gaylee0124
hohokus, US
Jan 15, 2010 2:13 pm EST

WE ARE A 7 DOCTOR PRACTICE WITH MANY UHC PATIENTS. THE REPS ON THE 1-800 LINE ARE ALL FOREIGNERS WHO BARELY SPEAK ENGLISH. THEY DO NOT UNDERSTAND YOUR PROBLEM AND I AM CALLING EVERY 2 WEEKS TO GET MY CLAIM REPROCESSED. THEY ARE RUDE AND EITHER HANG UP ON YOU OR LEAVE YOU ON HOLD INDEFINITELY. I JUST FILED A FORMAL COMPLAINT WITH THE NJ DEPT OF BANKING AND INSURANCE. I NEED EVERYONE TO COMPLAIN SO THAT WE CAN GET SOMETHING RESOLVED. OUTSOURCING CLAIMS DOESN'T WORK!

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serene761
US
Jan 02, 2010 11:30 pm EST

My husbands company just changed the insurance company to united health care. We were told by the UHC representitive that my sons speech therapies will not be covered. We have been paying them out of our pockets. Any advice?

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Hai, First of all strictly strictly dont purchase the travel insurance from this company(My suggestion) . When i started from new delhi india i took the travel insurance from icici lombard for 500000 (Five lakh dollars) with 100 $ deductable and one day i was ill and went to hospital and there the doctors performed my tests and suggested the treatment for...

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United HealthCare Services rip off agents

I contracted with UHC to sell their Medicare Advantage products (Secure Horizons and Evercare). These plans are under the jurisdiction of Medicare, or CMS for short

UHC had not paid me over $8, 000 in commissions dating back to Nov/Dec 2008. Their managers lied, stating that CMS did not allow such payments until CMS released an "approved" list of Medicare-eligibles. Medicare ha been very late in providing such a list, but, according to CMS, this is absolutely not true! CMS regulations state that they MAY, but are NOT REQUIRED to, withhold, that they MAY pay, and later reverse or charge back commissions if plan enrollees later turn out not to be approved by CMS.

To add insult to injury, UHC has FAILED TO RESPOND to my complaint letters, even though I sent the last one by certified mail, and I received confirmation of their receipt and acceptance of my letter - what kind of a flakey business is that ?!

In addition, no one would believe how much trouble agents had with UHC's computer system called "onDemand", which agents were supposed to use in tracking enrollees. Likewise, their agent support system was ATROCIOUS - I have copies of over 40 unanswered e-mails to their PHD )Producers Help Desk), and when I sent copies to the local managers (Tucson, AZ) I got no replies from those "wannabe's" either.

I recently filed a $10, 000 lawsuit (the maximum in Justice court in Arizona). It is standard practice in the insurance industry for agents to get paid first year commissions immediately when a case is approved, and then charge an agent back any "un-earned" commissions, if and when a policy is cancelled or lapses during the first year. I am convinced that UHC rips off agents like this nationwide; they must make tons of money off the interest on agents' monies that they decide to keep in their own bank accounts so long. The Arizona Insurance Department fined them $364, 500 for, among other things, "violating state laws governing ... timely payments to providers"; evidently UHC tried to rip off doctors and hospitals, etc. and now they seem to be trying to rip off agents nationwide in the same way. Based on my experience, in my opinion, this is a very bad company for agents to deal with.

If you have been an agent with UHC and had similar experiences, it sure would be good to hear from you.

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United HealthCare Services non-payment of claims

United Health Care is by far the worst health insurance company in the United States. It is by far the WORST Company I have ever tried to deal with. Just recently I had to have an MRI. My plan states that I have a 90% coinsurance. So when I received the bill I thought that it was a mistake that they only covered the procedure at 80%. You may think that’s not so important, but for an MRI that was over $200.oo dollars extra out of my pocket. I called them and found out that they would have covered the procedure at 90% if I had obtained the procedure at another felicity. But since my doctors office had the machine on site and there deal with United Health Care was different. That was all the coverage I was going to get. My problem here is that my deal with United Health Care was for 90% coverage and that is what I pay for each month out of my pay check. Now I have to be an expert not only at my own deal with these people but the deals of every medical felicity I have anything done at. How could a person possibly win at this game?

My plan states that Preventive care is covered at 100%. So naive person that I am, I went to my Gynecologist and had my yearly pap and mamo. This being the first preventive care I have done this year, I assumed it would be cover at 100%. Well guess what. They paid $91.00 dollars and billed me for $571.00 dollars. There explanation is that I have exceeded by plan yearly maximum for preventive care. These people just all should burn in hell. They are definitely scam artists and I am stuck with them for the remainder of the year. Is there anything I can do about it? Please help.

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Update by timandsusanj
Aug 16, 2009 9:05 am EDT

Quite honestly, your an idiot. I have had no preventive care at all this year and they are attempting to get out of paying my claim because I have max my benefits for the year? I think you are the one that doesn't understand. If you do some searching you will find the United Healthcare is currently paying off a law suite for this very behavior. Denying claims and lying to there members to keep from paying. Quite honestly, you are the one that doesn't understand, when I have it in writing that my co-insurance is 90% and they pay only 80%. This is hard to misinterpret.

I look very much forward to Obama’s reform because this country does need it. I think that your problem is that you work for one of these companies and are having trouble sleeping at night for the way they train you to treat your fellow human beings and you want to justify your behavior.

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Ron J1
Fort Worth, US
Jun 17, 2011 4:28 pm EDT
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BTW If you see someone who disagrees with a negative comment about the company, and especially if they have detailed knowledge about the subject, be immediately suspect. United Health Care probably uses standard social media monitoring practices. They probably have a call center. These people instead of taking calls would be getting alerts. They would be alerted anytime someone types United Health Care into a blog or new page etc. So then they go out and use counter tactics to improve how the "Internet" feels about the company. They will most times come in as anonymous and counter the claim. Sometimes not very professionally in my opinion. They will actually run reports on what the over all tone of the "Internet" is about their company. They use dictionaries of negative words and positive words. So "United Health care is a great company" would be one favorable comment counted towards them because of the word great. Alternately if you said 'United Health Care Sucks" it would count against them because of the word sucks. I purposely put the alternate in this comment so as not to give them credit or negative just by posting this comment. They are now even in the reports. I think most people realize there are company employees that argue on these blogs. I thought it was important to note however, on what a wide scale this is. These call centers may have 100's of people that do just this all day. Ron iChores iPad Jon.

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Ron J1
Fort Worth, US
Jun 17, 2011 4:17 pm EDT
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I have United health care. One two medications they now all of a sudden won't cover. What do they do? Talk about what a great RX benefit they have then just not cover most of what you need? Or only cover the cheap RXs?

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mgg
Pittsburgh, US
Mar 23, 2011 9:08 pm EDT

United Healthcare is not a reputable company in the way they sell their policies or process their claims. Their customer service (?) reps are rude and uninformed. If persons have a choice, they should not choose United Healthcare.

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cbeleele
Fort Smith, US
Nov 29, 2010 11:32 am EST
Verified customer This complaint was posted by a verified customer. Learn more

Does anyone out there know why Rose State College is involved with this company? Suddenly we ( retired group of teachers) have found ourselves committed as a group without much advance notice, automatically. This scares me but how do we fight it?

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tnleafer
US
Oct 22, 2010 4:20 pm EDT
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UHC is the worst.
I have 2500 in Hearing Care, they told me they had no network provider in my area, I saw someone outside the network.

Now they say they do have providers.

My coverage states that I have $2500 in hearing benefits, they sent me a letter highlighting the coverage and said that I have no coverage.

My insurance broker insists I am covered, yet I have no letter and no payment.

I am going to hire a 'Bad Faith' attorney - and go after them.

If everyone did that, they would hear it in their fat pocketbook.

This goes on, last Feb they sent our company a list of our benefits. They started denying all sorts of claims. Now they say they sent the wrong benefits sheet. (7 months later) and want to recalculate benefits received by our group.

I dont think you can find a worse policy.

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Jay6584
Everett, US
Aug 27, 2009 4:24 am EDT

I was a nursing assistant for 20 years, and United Healthcare was notorious among the patients... you might as well be asked to dragged across the street and given a cup with some pencils in it to cover your healthcare bill. In a recent survey of healthcare executives (really smart people that run hospitals and such) United Healthcare had a 91% unfavorable rating, the very worst of all the insurance providers presented. But guess what? In 2006, it received a 'Reader's Choice' award in Business Insurance magazine, an insurance industry rag. I would refuse to be insulted by signing on the bottom line for this company.

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bobtheman
US
Aug 15, 2009 7:26 pm EDT

Quite honestly, you don't understand your plan. It's not their fault you don't understand the limitations of your policy. They are not scam artists, you just didn't read your plan materials properly.

Why not call Obama? I hear he's all into demonizing insurance companies too.

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6:27 am EDT
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United HealthCare Services wont pay for lab fees

Be carefull with this health insurance. I called the cust. service # & went over my benifits. They said I was covered except a 20.00 copay. Okay / I went to the doctor & yes the vist was paid except for the 20.00 copay I paid. The problem was the blood work they said was covered wasnt & I got stuck paying the whole thing. I tried calling the cust service but & even told them the name of the person I spoke with that said it was covered. They didnt care one bit. They said they were not going to pay for the lab work. I makes me mad - I have insurace for what? I need my blood tested every 3 month because I have diab type 2. - There reps are not trained worth anything & if they dont know good luck!

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YoMammasLDS
Mount Airy, US
Jan 03, 2013 4:21 pm EST

My husband and I have had United Health Care (UHC) coverage for almost 20 years. I am a Type 2 diabetic, and I need my blood checked every 3 months, as well. As long as I have my blood drawn by the laboratory named in my coverage, the bills are paid. Even when a doctor has a drawing lab in her office, I do not trust the staff to send my blood to the correct lab for processing. So, I never allow my provider or her staff to draw my blood; instead I get an order for the blood work and go to the lab I KNOW is under contract with UHC and whom I KNOW will get paid for their services. Your doctor's office is not approved as a lab site, and UHC was correct in denying the claim. Where are you supposed to go for lab work? If you do not know, you need to find out. UHC will pay for lab work done by a lab contracted with them to process your lab work. The responsibility is YOURS to make sure the services you are receiving are from a contracted provider. NO, I HAVE NOT EVER AND DO NOT NOW work for them. I trained medical claims processors for Kaiser, and I worked in hospitals and for doctors for 30 years.

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10:00 am EDT
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United HealthCare Services claims denial/ non-payment

After dealing with insurance claims for several years now, UHC is definately the WORST in paying for claims. When confirming benefits their representatives NEVER tell you if a pre-determination is required on particular claims, therefore dozens of claims get processed and denied because their lack of explanation. Also they have come to the conclusion that although your benefits state IV Sedation is a covered benefit, they DENY it every single time its submitted. I have thousands of dollars in unpaid claims due to UHC, and the consequence is that the patient gets stuck with UNPAID claims and high bills even though they pay their monthly fees for this ridiculous insurance company that does not even care for covering healthcare expenses. It should be named United HealthSCAM!

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IHateUHC
Dayton, US
Feb 15, 2011 12:40 pm EST

Not only had UHC denied payments in certain cases at my employer, we have seen them actually pay a claim only to then reverse their decision and retract the payment! The federal and state governments need to investigate UHC!

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wailua
Orlando, US
Nov 28, 2009 9:59 am EST

I am having the same problem. I had emergency surgery for my colon had to have a temporary colostomy bag, the supplies UHC would not pay for.. (the bags OMG how was I suppose to use the bathroom), well I fought with them after paying for the first two months of supplies, which over the 2 months of being out of work, broke me. They are now paying half of the supplies but refuse to reimburse me for my expenses. I have to have the reconnection surgery in a week so I will be out of work for another 6-8 weeks and right now I can barely pay my bills.. this company needs to be checked out by the government for fraud.

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timandsusanj
Troy, US
Aug 15, 2009 5:41 pm EDT

No kidding. This is by far the WORST Company I have ever tried to deal with. My plan states that Preventive care is covered at 100%. So naive person that I am, I went to my Gynecologist and had my yearly pap and mamo. This being the first preventive care I have done this year, I assumed it would be cover at 100%. Well guess what. They paid $91.00 dollars and billed me for $571.00 dollars. There explanation is that I have exceeded by plan yearly maximum for preventive care. These people just all should burn in hell. They are definitely scam artist and I am stuck with them for the remainder of the year. Is there anything I can do about it? Please help.

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12:13 pm EDT
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United HealthCare Services terrible service/no coverage

While being insured with Golden Rule/United Health Care, I have had nothing but problems. I started my insurance coverage on Feb. 23, 2009, and my husband went to the doctors March 9, 2009 and they would not cover it. Then I went to the emergency room on May 31st, 2009 and my copay(which they call deductible) was $100. I was formally told by Golden Rule that was all I would have to pay $100 if I were to go to the emergency room. Well my final bill was $581.00 that Golden Rule would not pay. There answer was "We are sorry that you were not informed of how your coverage works." DO NOT DO BUSINESS WITH THEM! You might us well not have coverage!

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10:38 pm EDT
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United HealthCare Services claims they have no record of approval letter for surgery

My surgeon and I both received a letter from Medica - United Health Care that stated that I was approved for an open roux-en-y surgery that was good from [protected]-2009. I had said surgery 02-16-2009. The insurance company have paid for the surgeon fees, anestesia fees, CT scans, x-rays, labs, etc. I received a bill from the hospital for $47, 000. The insurance company investigated and their conclusion was that this service (the surgery) required pre-approval and that I did not have approval for this surgery, therefore I am responsible for the bill. Luckily, my surgeon had his copy of the letter. I faxed it to the insurance company and followed up with a phone call. I have not heard back. If someone scams an insurance company, they go to jail. An insurance company tries to scam a paying customer and what?

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FAMILY RIGHTS
Birmingham, US
Jun 17, 2009 4:11 pm EDT

CONTACT YOUR STATE'S INSURANCE REGULATORY OFFICE. IF YOU CANNOT FIND OUT HOW TO GET IN TOUCH WITH THEM, CHECK WITH YOUR DOCTOR'S OFFICE - AND THEY SHOULD KNOW.

CONTACT YOUR LOCAL BETTER BUSINESS BUREAU OFFICE TO FIND OUT HOW TO REACH THEM IF YOU CAN'T FIND THEM ONLINE OR IN THE YELLOW PAGES.

THIS IS A VERY COMMON PRACTICE WITH INSURERS. I HIGHLY RECOMMEND THAT YOU CONTACT THESE PEOPLE TO HELP YOU APPEAL THIS SHIFTY, DISHONEST TACTIC:

http://www.advocacyforpatients.org/health.php

THEY HELP PEOPLE FILE APPEALS TO THINGS LIKE THIS ALL THE TIME, THEY CHARGE NOTHING WHATSOEVER, AND THEY HAVE ABOUT AN 85% TO 95% SUCCESS RATE.

ALSO CONTACT YOUR FEDERAL REPRESENTATIVE (CONGRESSMAN AND/OR SENATOR) BECAUSE THEY ARE WORKING ON LEGISLATION RIGHT NOW THAT ADDRESSES INSURANCE COVERAGE IMPROVEMENTS -- AND THEY WANT TO KNOW ABOUT PEOPLE WHO HAVE BEEN CHEATED BY HEALTH INSURERS THROUGH TACTICS LIKE THIS. IT IS NOT UNCOMMON FOR PEOPLE TO HAVE PROCEDURES PRE-CERTIFIED, ONLY TO HAVE THE INSURER LIE AND SAY IT WAS NEVER APPROVED. IT'S HAPPENED TO ME.

CONTACT THE AMERICAN MEDICAL ASSOCIATION AND LET THEM KNOW ABOUT THIS. THEY'RE ADVOCATING FOR PATIENTS WHO'VE BEEN SCREWED OVER BY INSURERS. ALSO, YOU MIGHT WANT TO CONTACT YOUR LOCAL MEDIA, BECAUSE HEALTH CARE COVERAGE AND DENIALS ARE A VERY, VERY HOT TOPIC RIGHT NOW. IF YOU WANT, THEY CAN KEEP YOUR IDENTITY CONFIDENTIAL.

http://www.ama-assn.org/ama/pub/legislation-advocacy/current-topics-advocacy.shtml

http://www.voicefortheuninsured.org/sharestory.html

GOOD LUCK!

FIGHT THE HELL OUT OF THIS! DON'T LET THEM RUN OVER YOU!

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10:37 pm EDT
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United HealthCare Services eob - explanation of benifits

Several Explanation of Benifits indicate that the submitted claim was not paid because the physician was out of network. I've been with this Primary Care Physician for several years. I checked their directory of In-Network providers and he does appear on the list. To submitt an appeal you have to print and complete a form, then send it via postal mail. In this day and age of modern information systems you would think that United Healthcare could provide this service online. I would guess that they are trying to delay as long as possible having to address the complaints.

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markincleveland
Pepper Pike, US
May 31, 2009 12:01 pm EDT

So far this year UHC has paid five claims of ours as out of network for providers that are clearly in network. The reason they give is the provider billed for a code he is not authorized, an extended office visit instead of a regular office visit. This shift the entire claim to my out of pocket. If the provider made a mistake why should it be my responsibility? UHC is really disreputable.

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cgs
Leander, US
Apr 30, 2009 11:19 pm EDT
Verified customer This complaint was posted by a verified customer. Learn more

The doctors, clinics, etc should NOT be sending their patients to places for further treatment, that ARE NOT in the network, They are suppose to be knowledgable of whom THEY work with, so don't blame the patient. I see that as your screw up that you pass on to your patients!

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About United HealthCare Services

Screenshot United HealthCare Services
UnitedHealthcare is a leading health insurance provider in the United States, offering a wide range of health insurance plans and services to individuals, families, and businesses. With a mission to help people live healthier lives, UnitedHealthcare is committed to providing high-quality, affordable healthcare coverage to its members.

One of the key strengths of UnitedHealthcare is its extensive network of healthcare providers. The company has partnerships with thousands of hospitals, clinics, and healthcare professionals across the country, giving its members access to a wide range of healthcare services. This network is constantly expanding and evolving, with UnitedHealthcare actively seeking out new partnerships and collaborations to improve the quality and accessibility of healthcare for its members.

In addition to its network of healthcare providers, UnitedHealthcare offers a range of innovative healthcare solutions and services. These include telehealth services, wellness programs, and personalized health coaching, all designed to help members stay healthy and manage their healthcare needs more effectively. UnitedHealthcare also offers a range of tools and resources to help members make informed healthcare decisions, including online health assessments, cost calculators, and provider directories.

Overall, UnitedHealthcare is a trusted and reliable healthcare partner for millions of Americans. With its extensive network of healthcare providers, innovative healthcare solutions, and commitment to improving the health and well-being of its members, UnitedHealthcare is well-positioned to continue leading the way in the healthcare industry for years to come.
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Overview of United HealthCare Services complaint handling

United HealthCare Services reviews first appeared on Complaints Board on Feb 7, 2008. The latest review Ucard benefits owed was posted on Oct 11, 2024. The latest complaint laid off permanently due to outsourcing - and problems because of that was resolved on Jul 03, 2014. United HealthCare Services has an average consumer rating of 1 stars from 487 reviews. United HealthCare Services has resolved 49 complaints.
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    9900 Bren Rd E Mn008-T-615, Hopkins, Minnesota, 55343-4402, United States
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    Oct 16, 2024
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