United HealthCare Services
Reviews and Complaints

12/20/21 - Denial of claim stating "not medically necessary" when the claim had been approved 2 times before with the same filing, same doctor, same facility, same diagnosis, just a different date.

In lab sleep study approved on 10/20 through 12/31 and then again on 1/4/21 through 4/30/21. Approval code: A112563661 on diagnosis code g47.33, service codes 95810 and 95811. When speaking to customer service, the only reason this was denied after being approved twice was the date on the calendar, 12/20/20. My doctor did a peer-to-peer discussion on 12/21/21, and it was continued to be denied as "not medically necessary."

It was medically necessary and approved twice before, but since I put it off until I could get vaccinated in May 2021, and a booster in November, now I can't have the medical care I was approved to have and it's going to cost you more and me more because of it. More appointments to go through the extra steps so that I can get the health care I need and extra money billed to the insurance company and out of my pocket because of the extra steps, and higher risk of me dying without this care.

Also, I have met my deductible for this year and my in lab sleep study was scheduled for 12/27/21 - this year. Because of the denial for no reason other than the date on the calendar, it's been put off until 1/2022 and I have to start all over again and most of the cost will come out of my pocket. This sounds very fishy to me and unethical to deny service at the end of a plan year so that the insurance company, to whom I pay premiums 26 times per year, doesn't have to pay the first $465 plus any co-insurance.

I am also being denied medical care that could result in my death should I not wake up some morning because of sleep apnea, which my doctor believes I should be in the lab with technicians monitoring my sleep so that they can treat me right away. Now, it's going to be another month or more, plus, before a diagnosis and the correct treatment can be determined because UHC has denied a test that they have twice approved, once earlier in the year.

There is a recorded call dated 12/20/21 where I called United Health Care customer service to try and resolve this issue with them and they changed their procedures and told me that they don't approve in lab studies without first an in-home study. Well, obviously in the 2 times that it was approved before, UHC believed my doctor when he said it was serious enough that I needed an in lab study - twice - that was not preceded by an in-home study.

The actions of UHC are unethical, unfair and are denying me the needed healthcare I pay premiums to have provided to me and paid for by UHC. Having agreed on 2 previous occasions to pay for the in lab study and then denying it on the 3rd request because I was waiting for my vaccinations is unconscionable and a further risk to my health.

Also, I feel that UHC is continuing to deny this service because I made the Supervisor Clarissa mad on the phone call and this is retaliation for my using a colorful word on her recorded call.

In the beginning of October I was experiencing swallowing issues and losing weight rapidly, I had an endoscopy, attempted manometry, barium xray and many blood tests. My scans revealed lesions, damage and dysfunction of my lower esophagus. My doctor ordered a CT of chest and abdomen to further investigate and UNITED HEALTHCARE THAT I PAY FOR THROUGH MY EMPLOYER, DENIED AUTHORIZATION STATING: "NOT MEDICALLY NECESSARY" stating that I have NOT had an endoscopy, xray barium or blood work to show cause by THE MEDICAL DIRECTOR OF UNITED HEALTHCARE CHOICE PLUS! I called UHC and was told that the deciding factor was definitely due to that, and told me that the medical director does NOT HAVE ACCESS TO CLAIMS or testing...THEN HOW, HOW CAN YOU POSSIBLY DENY MY AUTHORIZATION STATING FACTUALLY, THAT I HAVEN'T HAD THE TESTS THAT I DID IN FACT HAVE, AND PROCESSED BY UNITED HEALTHCARE? I want them held accountable for denying me medical care! They are causing further harm to my health, I have waited 3 months and have lost almost 40 lbs and am choking and throwing up, DAILY! How is my CT NOT MEDICALLY NECESSARY?!? That human being should be ashamed of themself, but I am sure they sleep soundly making 6-figure salaries and allowing people's organs to shut down without allowing them to find out WHY THEY ARE SICK? How is this LEGAL?

Hello,
I am going to be having surgery for my neck in a couple of days. Two denials with one saying they need a bone density test before they can say my surgery is safe. I had a fusion from the same Dr in July. I did not need a bone density test then. My surgery is on Thursday. I have called 12 times in the last 2 days to get the proper information expedited to my Dr office so they can order my bone density test asap. They, including a supervisor have stated they are faxing it and it has to this time now NEVER been done. I am horrified by the lack of integrity these people have, especially for someone in pain. This process was started 11/18/21. I need to have this surgery so I can work to feed my family and try my best to have a normal life.

I provided a valid receipt for dental services to Optum Financial. The receipt had all the valid information - name of patient, detailed description of services rendered, the date of the service, the provider's name and the amount paid. Optum refuses to reimburse me until they receive a statement from the insurance company showing what the insurance paid. The requirement for a statement from the insurance company is not disclosed up front. The claim is submitted and not until you receive a rejection notice in the mail are you told that a statement from the insurance co. is required. I paid several hundred dollars for the services rendered. I put the money in my FSA account. I provided a valid receipt. I am entitled to be reimbursed the money I paid to the provider with the money I paid in to my FSA account. Date of service 29Nov2021. Claim submitted 29Nov2021. Rejection received 10Dec2021.

Had a house-calls visit on 10-5-21 as per promotion and told by visiting nurse that I would be getting a $50.00 Visa debit card within 6 weeks. As of November 2021 I had not received this debit card and was told it was mailed out on October 6, 2021. The agent told me they would send out another . As of today December 5 2021 still no debit card. called again and got the run around. could this be a sham?

I was forced to listen to a sales pitch, over an hour. NOW I have not been given ANYTHING I was promised!
FRAUD!

I was diagnosed coverage for a very aggressive form of breast cancer with a rapidly growing tumor and United Healthcare is denying my chemo.
They paid for the surgery to implant the chemo port, but they're denying the chemo itself. Are you kidding me. It's being administered at a private practice, not even at a hospital. Just ridiculous. A company that large should be prepared to pay for breast cancer. Its very predictable treatment. This is discrimination against women.

Requested Dr Pre Authorization - Oct 21 for Eliquis and Allopurinol, request disappeared from system.
Talked to representatives throughout the process to current date 11 Nov 21 and have accumulated almost 4 hours of hold time, talked to representatives that couldn't find my case numbers and filed multiple appeals to get my refills approved for a 6 month trip to Mexico.

UHC blanket refused to consider any facts in the case preventing either refill because I had asked for a vacation overide in March 21 for Eliquis, for about a two month supply which was granted. No vacation over-ride was requested or granted for any othe drug..

>This was time sensitive with an originally planned departure date of 14 Nov 21 and I filed an appeal for the vacation overide (18 Oct) and also for a benefits exemption (29 Oct), both with case numbers and was promised a 48 hour return on the vacation overide and a 72 hour response on the benefit exemption and to date have not had a response for either. >Additionally staff members seem to be unable to find either case number in their files.
>They cannot explain why I cannot get the normal vacation overide for Allopurinol since there was no previous request
>I filed a Medicare complaint and received a response on 11 October to call them.
>The Case Agent said she tried to call me three times, this is not true.
>I cannot get through to the case agent (10 tries) and she has no voice mail and there is no operator at the site.
>I called my provider AARP Medicare Advantage and was put on hold for more than 35 minutes and got cut off by their phone system. This is at least the 6th time this has happened and no one called back.
>My health and my life are being placed at risk because of an accounting decision
>There is no notice in their "plan manual" that they have this unreasonable and restrictive policy.

Member ID [protected]
James H Thrash

You Terminated my RX coverage, that I had for 7 years, for nonpayment because you changed, April 2021, the address you pull for billing to a 2 year prior address. I did not know that the representative had not updated the mailing address two years ago when I notified them of my move. They had always sent the bill to the primary address but once they change to mailing address in April 2021 I no longer received a bill. So three months later I get a phone call telling me that my account is being turned over to collection. The representative told me that if I paid the delinquent amount I would be reinstated but that was not the case they would not reinstate me so I have a gap of five months with no coverage which will cause a penalty from a new RX coverage Company. Totally your fault.

Your customer service refused to remove my wife (Cathy Dycus) who passed away from cancer from your mailing list. The address is 105 Windjammer Ln. Third Lake IL 60030.
I also do not understand why I have to add any additional information to get this reviewed and resolved.

I joined the UHC AARP Select G Plan over a year ago. The statement by UHC in a document named "GU25126LA_ART_agvf_wc.pdf" located at the address https://www.aarpsupplementalhealth.com/content/dam/ole/MedSuppDocs/YourGuide/StateVariations/GU25126LA_ART_agvf_wc.pdf, which is a Louisiana version of a plan description,

"Right to Replace Your Medicare Select Plan
You have the right to replace your AARP Medicare Select Plan with any other AARP Medicare Supplement Plan, insured by UnitedHealthcare, that has the same or lesser benefits as your current insurance and which does not require the use of participating providers, without providing evidence of insurability."

assured me that I could later replace my Select Plan G with a Plan G without evidence of insurability.

I have generally found the plan services to be excellent, but have decided I would like to exercise the above described right and move to a Plan G at the slightly higher premium without the need to provide evidence of insurability.

I was disappointed to hear one of their representatives tell me that they are not standing behind their above promise, and to tell me that I must provide evidence of insurability and be subject to a higher "level 2" premium if warranted.

I am hoping that this is just a misunderstanding on the part of their representative, and that they are not promising in bad faith to citizens of Louisiana, and AARP members, the rights to conversion from Select Plan G to Plan G without EOI.

United Healthcare has been worst insurance provider ever! Drs in their network yell and hang up in patients faces, Doctors discuss negatively about patients with other bad doctors! HIPPA violation. Customer Svc reps are unknowledgeable, rude, uncaring and unhelpful to say the best! My doctor has done nothing except benefited financially from me in over 3years! I've requested new doctor for 6months now? Good luck! Huh! All she good for is yelling and then hanging up in your face, then discussing you with her other doctor inept doctor friends? This doctors refusal to address my medical needs has landed me in ER twice, where my BP was 248/130 something; then, 234/116 less than a week ago. Trying to get help from United Healthcare is to no avail? I'm leaving this money grubbing company. Good luck & God Bless whoever stays with United Healthcare! The horror stories from everybody I met that use them, is endless. What a shame.

I called UHC at 1-888-8675562. All I wanted were my 2019 records. I asked for my detailed payment records and any other records available. After a very long time, I was no better off than before I called.

The UHC employee was rude and insolent and did not help me at all.

From the VERY beginning, anything I said to her, be it a statement or question, would result in silence. After a minute or two, Her responses were either untrue or irrelevant and worthless. After my last requests to her to give me the phone number of her manager and phone number for the off-site location that has my records.

Initially she told me I could not obtain my records because my file was closed. I told her that I knew that.

Then she told me that none of my 2019 records were available. I couldn't get them. Then she told me that she couldn't access them as they were off-site. Another time she told me that she could only give me the notes in my file. (That was really odd.) My last conversation was (again) after other requests earlier in our conversation was to again put me on hold. Except after quite awhile, (15 minutes/1/2 hour - probably more. A electronic voice operator replaced the silence. The call was over.

I told her that I needed this. I said I needed my Part D records. The conversation ended when I again (one of several times) requested the phone number of her manager and the phone number for the off site place where she told me my file was was located. (During our conversation I asked for it several times. She wouldn't give it to me.

After I asked a question or made a statement she would not respond for quite awhile. (I am guessing th time lapse was more than a minute. (I started timing it after a few minutes.) She may have put me on hold or disconnected me-I don't know.

First she told me that my account was closed. Later she told me that no-one could help me for that reason. I told her that this involves a possible legal matter and I am legally entitled to my records.

Several times I asked for her manager's phone number and the off premises site where my file was. Her response was that they could only give me the notes on the file. I said I wanted everything on the file inclusive of payment records (inclusive of who they paid, etc.) The last thing that I requested before she put me on hold for the last time were for the requested phone numbers.

By hanging up the customer service representative prevented me from answering survey questions on her.

I suppose it is possible that this employee is mentally challenged. Then it is not her fault that her "customer service" was nonexistent. More likely she is capable of doing a good job, but she does not care about the quality of her performance. Regardless of what causes her inappropriate behavior, this customer service person needs training in etiquette, knowledge of her products, how to retrieve data and how the system works (regarding medical records, etc.)

This was one of the more peculiar conversations that I have had with a customer service employee in recent memory. What I can't figure out is why this customer service employee didn't just do the easy thing and just give me the phone number of her manager or the phone number of the off-site location where she said my file was stored.

NOTE: I HAVE NO ACCESS TO MY UHC INTERNET ACCOUNT.
My current address:W52N138 Pioneer Court; Cedarburg, WI 53012
E-mail [protected]@gmail.com
My account MAY have been: [protected]-1

Thank you.

We are a Specialty office for Allergy. Every time we billed United Healthcare for allergy serums, they are paid, then taken back. Even when they ask for medical records, the response we get back doesn't match the records we sent. It's like they are making up nonsense and then retracting the money. EVERY claim for serums (95165). There is no respresenative to contact. No one in claims know what to do and I can't get a hold of a supervisor. All patients benefits are checked before services rendered and this is a covered benefit.

Dr. Warren Pleskow NPI [protected]

I am writing behalf of Samaritan Counseling Center, Illinois. We are currently owed approximately $10, 000+ in which the payments were issued via checks and virtual credit cards but never reached us. I have talked to numerous representatives from UBH and Optum pay that keep stating they see my calls and are reissuing the payments. Optum keeps saying that we have to speak to UBH since some of them are over 13 months old. When we do get someone we can be on the phone for an hour and then get disconnected and never receive a call back, why take my number if you don't call back? We need someone that will handle this matter and handle it promptly!

I will not upload EOB's due to HIPPA!

Two implants under plan in 2020 were approved, implants are a multi step procedure over time that went into 2021 for last phase of crown onto metal implant is now being denied code payment although the codes are approved 5 years in length in code book at dental office. After many, many months of stall & denial by UHC, got an answer other than not right codes, that Medicare as of Jan., 2021 supposedly is only paying for crowns onto existing tooth and not metal implant screw. (2020 contract for these implants were to be fully paid under my HMO, UHC plan and not to be changed in mid stream or at the final phase of the procedure, this is basic contract law, and i'm now being denied completion of the full implant process) William J. Gozza Utopian Dr E. #119, Clearwater, FL. 33763...[protected] Member ID [protected] Health Plan #[protected] (HMO D-SNP)
Dual Complete LP-FL

Erica Essner
656 10th Street
Brooklyn NY 11215
[protected]@icloud.com
[protected]

Dear United Health Care:

I am writing to discuss a financial issue and possible lawsuit I am considering bringing to United for failing to keep me enrolled in my insurance when I had paid my premium.

I am writing this letter to inform you of two clerical errors that occurred on behalf of UNITED HEALTHCARE which left me uninsured in a pandemic for six months, and then later in 2021 when I signed on to a new plan through the New York State Market place.

I was on cobra for four years after my divorce in 2016 through ADP Total Source through July 2019. In June 2020, ADP Total source informed me that they would terminate my insurance in July 2020. In June 2020, I then went to the New York State Health Market place to enroll in a individual plan with United compass gold. Since ADP did not cancel my cobra United was unable to start the new plan. I spent the next 6 months on the phone with the New York State Marketplace and United. United representatives could not track the policy, nor could they re-enroll the me in individual insurance as they were not able to find the records. This cost me endless hours on the phone with United and uninsured during a pandemic from July 2019 -December 2019.

I finally was enrolled in December 2020 with Compass Gold. I went to re-enroll for 2021 and for some reason was not re-enrolled and was again left uninsured for the month of January 2021. I then left united for Empire.

I am seeking re-imbursement for my time uninsured from June 2019-December 2019 and
Reimbursement for the three weeks in January 2021 I paid my insurance, but it was not processed.

These accounts should all be reviewable Erica Essner 4/21/62 SS#[protected]

I would like to avoid litigation and look forward to hearing from you.

Best

Erica Essner

United Compass GoldMember ID [protected] group 0755 481

I want to add to the list of complaints about outsourcing customer service. I am a healthcare provider and can barely understand the customer service rep as she is clearly not a native english speaker. She promised to send me a code so I could log in to my provider account within 15 minutes and it did not arrive. She probably misunderstood my name spelling. Their websites are complex and I could not log in nor did it say that I needed a code. Unacceptable.

I called and inquired if my place of business needed to do a retroactive PA for services provided. Jaycee from UHC informed me that I needed to alter dates of services provided in order to have services covered. I spoke with Jaycee for 1 hour on 8.24.21 call ended 11:50am. When I asked to speak to a supervisor I was put on hold for 15 min. Then told the supervisor was busy and they would call me back.

I am getting very disgusted and annoyed with United healthcare. I've called him up at least five or six times during the last month about my complaint. About 2 months ago I received a letter from United healthcare to receive a Visa rewards card for $25 if I have a medical person give me a physical I did that about 6 weeks ago and they just sent me a $15 gift card about a month ago I've called and complained as I said at least five or six times until my wouldn't have never had anybody come over my house to give me a physical I would have never wasted my time for a mere 15 dollars, somebody at United healthcare customer service told me it's no use writing agreement that they are not going to give me the other $10 at I feel I am old since the letter that I received about 2 months ago said $25 not $15 I know how to read unfortunately I believe I might have put the letter and recycling I did not think that I would need to keep it for proof.