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I have been struggling with United Health Care for the past SIX months for paying the lab tests as a result of an annual physical at a laboratory that is in-network.
My son went to the doctor for his annual physical, the doctor ordered a blood test. United claims that the claims submitted by the lab consisted of 1. Blood draw, 2. Metabolic Panel, 3. Hepatic Panel, 4. Lipid Panel, 5. Thyroid and 6. WBC blood count.
(Note that the lab results for Metabolic Panel and hepatic panel equals the results for Comprehensive Metabolic Panel. (2+3 = Comprehensive panel)).
They did pay for the doctor visit 100% as it was for a preventive care (my policy covers lab work also 100% as part of the physical. Wife unit and I had exactly same tests done as part of physical, and we did not have to pay).
Initially, they refused to pay for any blood work saying that those tests were not for preventive care they were diagnostic (if classified as diagnostic the claim is subjected to deductible and 20% co-pay).
Then they agreed to pay only for Lipid Panel (even refused to pay for blood draw). Then after a fight agreed to pay for WBC blood count, then Thyroid, and then finally blood draw (I had to argue that how can they do all those covered tests without drawing blood).
They claim that because of Obama Health Care reforms Metabolic and hepatic panels are diagnostic, but comprehensive metabolic panel is preventive (I have heard about Obama health care reforms six different times).
Imagine going to MCD with a free coupon for a happy meal, but the cashier decides to break down the chicken, fries, drink, and the toy and then saying that the happy meal coupon is not valid.
I just do not know how to proceed with them. Every call is handled by a different idiot. That idiot just wants to pass the buck, and it is in their advantage to keep on wasting time they must be charging my employer for the time spent on me.
Sorry for the rant, but any suggestion would be welcome.