I know they shouldn’t, but we wanted our coverage taken care of and it was the only way it was going to happen, short of hiring an insurance advocate who does this as a career, which we seriously considered, and I interviewed someone over the phone for this job. We don’t have a choice with UHC - they are a carve out for some parts of our insurance. For the rest of our insurance, we have BCBS, and they have been pretty good.
When you have choices, obviously don’t choose UHC, but when it’s already happened and you’re trying to get them to make payments, desperate times call for desperate measures.
We have GEHA, which used Alliance to administer and process claims. Our docs loved them. Three years ago, they switched to UHC for claims processing/administration. Almost every CSR at GEHA that I’ve talked to hates UHC. The CSRs have no control or ability to get things corrected any more, It gets sent to another department so someone who has no context can take a stab at it. A couple of my docs say UHC has seriously reduced reimbursement rates. Some of my docs are OOP (given my medical issues, this is necessary), and they are not happy either. Of course, we get to pay for this incompetence.
I had a claim recently where I spoke with 11 different people (all conversations documeneted :)) before the issue was resolved.
Teri: I’ve done the same thing you have. I document every call, getting numbers I can call back. One rep gave me a “special” fax number and her own extension. I called and left her TWELVE messages which she never returned. Have not heard from her since. The fax line didn’t work. You can only stalk them if they answer their phone. You can only talk to supervisors if they will connect you. The majority won’t give you their last name or a phone number. Some give you a “reference number” but when you call back it doesn’t exist.
As I said, the only one who has occasionally responded is the Attorney for UHC who was in charge of the case when the hospital sued us. And even she takes weeks to respond claiming to have been on vacation or just plain ignores me until I threaten something. She assures me others will be in contact and they have never called.
I had a direct contact, a clinical person at UHC who was “supposed” to help me resolve the reimbursement problems. It seemed more like a stall tactic, with many rounds of “give me a few weeks to look into this and I will get back to you”, that got me nowhere but increasingly frustrated as the weeks and months passed with no resolution. They really should be ashamed of themselves.
On of my professional organizations is trying to address the blatant discrimination occurring at the hands of Cigna. Stay tuned.
I’m another one who will avoid UHC at all costs. H used to have to deal with them on his parents’ behalf and they screwed up every single claim the first time. And every single time they blamed it on getting incorrect info from the his former employer (he had retiree coverage). Funny none of the other providers over the years have ever had consistent problems with getting incorrect info from the employer.
My H turned 65 recently–even though he’s not retiring–he signed up for Medicare and purchased a BCBS supplemental policy. He’s had no problems with the BCBS supplemental policy. It’s higher than the others, but we haven’t had any issues.
To update in case anybody ever considers buying a UHC policy:
I have a special claims person assigned to my case. I have her name but she won’t give me her number. I have a Corporate Claims specialist whose name and number I do have. She is the one who assigned a special agent to my case. I also have the name and email address of a legal representative.
Yet when I submitted my prescription claims for January and February on March 3, they paid my claims and mailed me a check but the claims for my husband submitted in the same fax and same envelope as mine were paid TO THE PHARMACY instead of to us. I called the special claims person on Thursday and she didn’t return my call so today I called the usual number I have and they are the ones who told me what happened. I then called the Corporate claims specialist and told her if I don’t hear from her today I would file a grievance with the state. I then emailed the legal counsel and told her the same thing. The legal counsel emailed me back and said “I have reached out to management for input. I will be in touch”. The Corporate claims specialist told me she had contacted my special claims person assigned to monitor my case and I would hear from her first thing in the morning. She apologized again and told me this should not have happened since someone is monitoring my case. Yet it did. Again.
I guess my only option is to file a grievance with the State but I honestly don’t know what good that will do.