I'm frustrated with United Healthcare
Those of you who know me well are probably tired of hearing it's been a tough year, blah, blah, blah. It has been. My group at BURRIS and I have gone through a transformation for the business that has at once been optimistically conceived and realistically implemented. In other words, we work hard to be what we think we need to be to be successful, but there have been times when we've actually been what we HAD to be in order to make payroll.
Anyway, no more on that. I promise. I'll save it for the history book ... or for the eulogies someone else can deliver.
When you're going through the daily slog, however, sometimes trying just to get it to the next day, the last thing you need is to get bogged down by something you count on working smoothly. Yesterday was one of those days when - well, geez, I just can't believe what happened.
Apparently it began last week. Our own Lyn "I do it all" Rollins was on vacation, apparently doing what we all do when we're on vacation: she was in the drive-thru line at her local pharmacy picking up a prescription. The attendant on the other side of the metal drawer informed her that her - our - insurance had been cancelled, and Lyn would have to supplement with more than her share of the co-pay.
Now, fortunately, Lyn is also the person responsible in our little company for the relationship with UHC, United Healthcare, our healthcare insurance provider. So after getting over the shock of learning we've been cancelled, she pulls her car to the side and dials up her contact to ask what's up.
A bit more background...
Faced with a 20%+ increase in premiums and the de rigueur reduction in services, we cobbled together a different employee health insurance plan this past Fall. The new program (I don't recall the reason, but it probably didn't make sense then either) could not be enabled 'til the beginning of the calendar year, so what we had to do was offer a kind of amalgam of the old and new from October through December, then transition to the new program on January 1. (Stay with me a second; this really is relevant.)
So for three months, Lyn (who also, by the way, pays the bills) would send a check to UHC, and they were to apply one portion of the payment to one program, another to the, uh, other program. Sounds confusing, but this is what UHC required.
Well, apparently, what UHC's accounting department was doing was applying one portion, but not the other. So come premium-due-day recently, with an eye for folderol and armed with a bureaucratic, "this is how we do it" policy, some QWERTY-striker at UHC double-lined us from the rolls of active premium payers, incorrectly considered us policy non-paying deadbeats, and - this is the kicker - cancelled one of the key parts of our "amalgam" coverage.
No call, no registered letter, no email, no visit ... nothing. Poof! Cancelled.
Doomsday scenarios are everywhere in this kind of thing, but, fortunately, the worst thing that happened (we think) is that Lyn was denied co-pay at the pharmacy.
But there have been plenty of the "can you believe?" questions in the last few hours.
For instance, can you believe that UHC still hasn't straightened out their accounting mess? Can you believe we had to wire ("Wire!") a partial payment yesterday to cover the account? (They couldn't just move the overpayment for the one they credited to the one they didn't.) Can you believe that it takes 48 hours before our prescriptions policy can kick back in? And can you believe that no one with whom Lyn has spoken from UHC can explain why this happened, why they didn't contact us BEFORE cancelling our policy? Much less apologized for the inconvenience.
We all have (and continue to) read about the problems, the crisis in healthcare this country faces. It's just too much for me when I compound that with the combination of hubris and ineptitude that we have faced on more than one occasion with United Healthcare.
There's no way these people could survive if they had to perform the way a normal business does.
Anyway, no more on that. I promise. I'll save it for the history book ... or for the eulogies someone else can deliver.
When you're going through the daily slog, however, sometimes trying just to get it to the next day, the last thing you need is to get bogged down by something you count on working smoothly. Yesterday was one of those days when - well, geez, I just can't believe what happened.
Apparently it began last week. Our own Lyn "I do it all" Rollins was on vacation, apparently doing what we all do when we're on vacation: she was in the drive-thru line at her local pharmacy picking up a prescription. The attendant on the other side of the metal drawer informed her that her - our - insurance had been cancelled, and Lyn would have to supplement with more than her share of the co-pay.
Now, fortunately, Lyn is also the person responsible in our little company for the relationship with UHC, United Healthcare, our healthcare insurance provider. So after getting over the shock of learning we've been cancelled, she pulls her car to the side and dials up her contact to ask what's up.
A bit more background...
Faced with a 20%+ increase in premiums and the de rigueur reduction in services, we cobbled together a different employee health insurance plan this past Fall. The new program (I don't recall the reason, but it probably didn't make sense then either) could not be enabled 'til the beginning of the calendar year, so what we had to do was offer a kind of amalgam of the old and new from October through December, then transition to the new program on January 1. (Stay with me a second; this really is relevant.)
So for three months, Lyn (who also, by the way, pays the bills) would send a check to UHC, and they were to apply one portion of the payment to one program, another to the, uh, other program. Sounds confusing, but this is what UHC required.
Well, apparently, what UHC's accounting department was doing was applying one portion, but not the other. So come premium-due-day recently, with an eye for folderol and armed with a bureaucratic, "this is how we do it" policy, some QWERTY-striker at UHC double-lined us from the rolls of active premium payers, incorrectly considered us policy non-paying deadbeats, and - this is the kicker - cancelled one of the key parts of our "amalgam" coverage.
No call, no registered letter, no email, no visit ... nothing. Poof! Cancelled.
Doomsday scenarios are everywhere in this kind of thing, but, fortunately, the worst thing that happened (we think) is that Lyn was denied co-pay at the pharmacy.
But there have been plenty of the "can you believe?" questions in the last few hours.
For instance, can you believe that UHC still hasn't straightened out their accounting mess? Can you believe we had to wire ("Wire!") a partial payment yesterday to cover the account? (They couldn't just move the overpayment for the one they credited to the one they didn't.) Can you believe that it takes 48 hours before our prescriptions policy can kick back in? And can you believe that no one with whom Lyn has spoken from UHC can explain why this happened, why they didn't contact us BEFORE cancelling our policy? Much less apologized for the inconvenience.
We all have (and continue to) read about the problems, the crisis in healthcare this country faces. It's just too much for me when I compound that with the combination of hubris and ineptitude that we have faced on more than one occasion with United Healthcare.
There's no way these people could survive if they had to perform the way a normal business does.
posted by Mark Burris - BURRIS at 12/14/2005 07:56:00 AM
20 Comments:
My sympathies. This is the biggest racket and they are the worst ever. You should send this to 1,000 of your nearest and dearest friends. Merry Christmas and bah humbug from UHC!?
Great blog I hope we can work to build a better health care system. Health insurance is a major aspect to many.
Hi
This United Healthcare thing is getting worse as time goes by. Now they do not even serve our lcoal hosital and it's team of doctors. In addition to be in an insured, I am also an employer and the cost is crazy while United is so uncommunicative it stinks. I don't know who is pocketing the cash, but United Healthcare must be right up there. If ony we coudl get answers and decent service. The have an "in touch" e-mail address but I think it goes straight to their Norton recycle bin.
Their Norton recycle bin and the Big Dogs pocket. Shameful way to run a business and to treat the people.
Anonymous says...
All Hell has broken loose in West Virginia with UHC. First they purchased a regional carrier, MAMSI, then proceeded to terminate the contract of WV's largest, best, highest quality care provider, Charleston Area Medical Center...which, by the way, encompasses three hospitals. UHC had an opportunity to come to WV and establish itself as a quality carrier but instead has tripped on it's own greed and selfishness. Out with UHC....we love you BCBS.
I worked for UHC when it bought out John Deere Health in February. I quit in June as it was a huge, poorly run organization that was only interested in takeovers. Unfortunately their transition was not well planned. Staff members with long tenures at John Deere Health are leaving in droves. I am glad to be out of that mad house.
I just received a letter from my doctor yesterday informing me that he is cancelling his contract with UHC starting Dec 01, 2006.
In the letter, he mentioned that UHC has gone great to bad. They now pay the health provider at the rate of what MediCal pay which is a barely minimum.
Goodbye UHC !
So sad ...
UHC just doesn't pay. My father-in-law has run up over $85,000 dollars in his end-state renal care. UNC is obligated by Federal Law to pay, but they just won't pay. They don't answer letters. They don't do what they say on the phone. They don't answer the phones in a timely manner. They will not recognize their obligation under the law. This experience has made completely in favor of NATIONAL SOCIALIZED MEDICINE as the only alternative to this b.s. Anyone who says that the private sector is good at providing health care is an idiot. Health care in the United States has degenerated into a profit-making racket in which innocent people get killed while executives who are little more than criminals put the money in the bank. I want it all shut down. All of it. One national data center with a single file of medical records for each person. One set of policies that everyone understands. One set of rules that everyone can live by.
I live in the New Orleans area. UHC has bought out other insurance companies here. The service used to be okay - no complaints; however, since the end of 2005 it has changed. When you write appeal letters, they do not bother to mail them; they have cancelled authorization numbers for services and do not bother to contact the patients so the patients incur treatment without coverage; they routinely deny services where the contract states services are to be covered and their care coordination and claims department are on two completely different systems so there is no communication between the two. I have contacted claims to be told they do not have an authorization number and that I had to contact care coordination and tell them to send it to them. I did this no less than 12 different times (documented) and with no call lasting under one hour (holding on an average of 50-80% of the time while they "research") and it was to no avail. Eventually, I had to write the Better Business Bureau to get the claims paid. In the interim my relationship with my autistic son's speech therapist deminished and we have no where to go because he is the only specialist in the area who can help him. Criminal. I implore you to write these complaints to your state commissioner of insurance. I've already started my letter.
UNITED HEALTHCARE is in the Business of MAKING MONEY - not in consumer health care. The contract co-pays are actually HALF of your out-of-pocket expenses. After enrolling, they change the plans and deny expensive RXs such as Nexium and Imitrex (usually after your first rx is filled, they then change the plan & no longer approve that medication). Their Customer service SUCKS (877)782-7862. They promise to ship (mailorder) and then don't ship. You have to call and call and call to get them to ship the meds! After 8 years with these unprofessional jerks - I'm DONE!
UHC is just ike Bear stearns selling Crdit Defallt Swaps. They hire tons of programmers but cannot have a simple program to figure this out? No one can understand it. If no one can understand it, and it takes a PHD to read it, it will blow apart, just like Wall Street.
I have been in a UHC nightmare since June 2, 2009. I have torticollis and receive treatment from OHSU in Portland. The treatment consists of Botox injections in my neck to stop the tremors. The treatment changed my life.
On June 2, I went to the Neurology Clinic for my treatment only to find that OHSU cancelled my appointment because UHC would not pay for the Botox unless is was purchased from Pharmacare (thanks for the notification). OHSU won't use UHC pharmacy so I have been in essence denied coverage. This is a covered service (according to the contract), but I can't receive care from my doctor of the past three years. UHC wants me to find a new doctor. This is a specialized treatment and very few doctors are trained in this area.
Could socialized medicine be worse?
Maybe it is already here.
I have problems with UHC since March 27, 2009 and that was the date when my daughter was born. Apparently they do not want to pay for an IUD device and everyone is suggesting that I should get the device from the manufacturer.... I mean, are you people nuts.... the premiums are going through the roof and I cannot get a device that would help me prevent child#3...... This should be illegal. Is there anyone out there with the same issue? I would love to get a lawyer on the case but I would need others to join me..... (eszter1313@yahoo)
I've had UHC for over a year now and never had to use it. Two weeks ago I blew out my knee in a training accident. It's not connected anymore. Can't stand up, lots of very acute pain. Getting no sleep. I went to the ER after it happened for an Xray. No broken bones. Then I went to one of the nations premier Orthopedic specialists. He's actually a team doctor for the Washington Redskins. Naturally, since he doesn't possess the capability to look inside my knee with a magic eye, he sent me across the hall to schedule an MRI. That's where the UHC mess begins. Their policy is that they have a week, that's right, a week to determine whether or not the MRI is necessary. It's been far longer than that and I'm still sitting here with no 'authorization code'. I could be in post-op recovery right now and on my way back to training but instead I'm still sitting here with the same busted knee and no idea when I'll get it fixed. I have spent hours, and I mean hours, wandering through a dizzying labyrinth of UHC phone numbers, automated messages, non-industry standard jargon (which I'm convinced is designed to prevent care through confusion), and on the odd chance I have ever managed to speak to a real live person I can hear them shrugging on the other end of the phone with a canned "I don't have anything in the system regarding your request" response that makes my blood boil. If anyone, individual or employer, is even remotely considering UHC as an insurance company I would strongly advise you think hard about that decision or be very very careful from there on out because if you get injured, you are about to enter one of the biggest medical shell games in existence. They happily take your money, then employ slight of hand bureaucratic games to ensure that they don't have to provide any service. I've never, ever had such a horrible experience with a more criminally inept organization in any industry.
UHC is crazy. I work their today and let me tell you I am glad I found a job in this crazy market. Put Uhc doesn't care about their employees so I know they dont care about the insurance holder(the ones that pay for the health care the ones that pay my bills as well) its a health care and they won't even let their employees get off to go to the doctor. and if you are pregnant and miss a day to go for a check up uhc has claims adjusters who have no clue whats going. we send claims back for providers all the time. because we at uhc messed at but they tell us to never say that. I have had so many bounced checks that uhc has had to pay out on because as it has been stated in this blog their accounting dept has no clue about whats going on. its sad but nobody other than supervisiors and managers get the best part of the deal. I am speaking from a Managers point of view. I feel back for my staff and for those that have had this bad issue with uhc. I used to her providers say all the time uhc is the only insurance that requires this. Its no wonder I have my family with BCBS. they are great.
Sunset Strip Medical Center in South Florida combines board certified physicians with superior healthcare services in an affordable and compassionate manner.
My paycheck is being garnished because the Hospital ER room I went too would never file a claim to UHC. I gave the ER admin where I worked and that UHC was my Healthcare Insurance company and called Hospital three days later with the actual member number but somehow I was flagged as uninsured. The EMSA ambulance was able file claim but not the hospital. Here is where UHC comes in... I lobbed 10, 15 calls into UHC asking my options and during the first couple calls I was put on hold while UHC talked to my Hospital in Tulsa, OK and would come back to me saying everything is good and to have no worries only to find out each time "no" nothing happened. The hospital is at fault mostly but what prompted me to write on this blog was the systematic lies that UHC would feed me stating all was good. I had messages stating they were in contact with the collector only to find out they never called them at all. Each call gave to UHC revealed me one more thing they forgot to tell me or they would contradict the call to UHC the day before, the hour before. I faxed them my billing so they could key it in and start the claim to be submitted only to find it was rejected or explain to the "resolution center" second tier support people that it was my fax and not the hospital. Shocking, shocking incompetence left and right with UHC. One gal told me she going to take ownership of my problem and in the same breath she was going to take next week off. Meantime my paycheck is being garnished. I reached up to the company's highest Human Resources officer and they have asked the UHC rep for our company to intervene. Magically the hospital is filing a claim now but truly after all the false starts i have my doubts anything will happen. The collectors are tagging me for $5000 for a 40 minute ER visit. Our healthcare industry is a huge ripe off. I am ashamed this is our system to hoist up as the model of the world. You have got to be kidding me...
The current economy is very difficult everyone has to work harder and achieve more whilst getting paid less.
I started accepting then Unison HMO medicaid, they were bought out by/taken over by UHC recently. They send my small checks for payment with one of my Employee's name listed on the check! No one in their office thinks this is wrong! They are very hard to deal with on the provider side too. I will stop taking UHC for payment if they don't change( or at least call me back).Fundamentals in SC.
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