Terrible United Healthcare

[MassWineGuy]

I got a Covid test in January at a local pharmacy. The criminal enterprise known as United Healthcare denied the claim saying it was out of network. The CARES Act of 2020 mandates insurance companies to cover Covid tests either in or out of network.

First, it was because the correct procedure codes weren’t submitted. UHC contacted the provider who then sent the requested codes. That was about a month ago.

I’m nearing my limit. I’d like to make an expensive example out of UHC by recovering a lot more than the claim asked for. I haven’t decided yet, but are there lawyers who would be interested? I’m not paying out of my pocket. They can have the standard one third of the awarded amount.

 

[bacha29]

I got a Covid test in January at a local pharmacy. The criminal enterprise known as United Healthcare denied the claim saying it was out of network. The CARES Act of 2020 mandates insurance companies to cover Covid tests either in or out of network.

First, it was because the correct procedure codes weren’t submitted. UHC contacted the provider who then sent the requested codes. That was about a month ago.

I’m nearing my limit. I’d like to make an expensive example out of UHC by recovering a lot more than the claim asked for. I haven’t decided yet, but are there lawyers who would be interested? I’m not paying out of my pocket. They can have the standard one third of the awarded amount.

There should be several public agency's, consumer advocate, state department of health, state attorney general's office who can help you. I seriously doubt that the potential award would be large enough for a attorney to take on the case.

 

[MassWineGuy]

I’m sure you’re right.

 

[FedexCares]

I got a Covid test in January at a local pharmacy. The criminal enterprise known as United Healthcare denied the claim saying it was out of network. The CARES Act of 2020 mandates insurance companies to cover Covid tests either in or out of network.

First, it was because the correct procedure codes weren’t submitted. UHC contacted the provider who then sent the requested codes. That was about a month ago.

I’m nearing my limit. I’d like to make an expensive example out of UHC by recovering a lot more than the claim asked for. I haven’t decided yet, but are there lawyers who would be interested? I’m not paying out of my pocket. They can have the standard one third of the awarded amount.

I’m hoping you just had some bad luck and United health care won’t end up being worse the anthem even. I’m about to rack up some serious medical bills due to a bad knee and I’m seriously dreading having to fight the insurance company on top of this.

My plan is supposed to be 3200 max out of pocket so theoretically I shouldn’t be paying out of pocket more than that on a surgery/rehab that is probably going to cost around 50k, but we’ll see I guess. I swear as I age and finally have to start using health insurance that I really haven’t touched for a decade, you start to see how screwed up our healthcare system really is.

 

[falcon back]

I got a Covid test in January at a local pharmacy. The criminal enterprise known as United Healthcare denied the claim saying it was out of network. The CARES Act of 2020 mandates insurance companies to cover Covid tests either in or out of network.

First, it was because the correct procedure codes weren’t submitted. UHC contacted the provider who then sent the requested codes. That was about a month ago.

I’m nearing my limit. I’d like to make an expensive example out of UHC by recovering a lot more than the claim asked for. I haven’t decided yet, but are there lawyers who would be interested? I’m not paying out of my pocket. They can have the standard one third of the awarded amount.

You struggle with obtaining the proper license to perform your job. Now you have insurance issues. Maybe you are the problem.

 

[yadig]

You struggle with obtaining the proper license to perform your job. Now you have insurance issues. Maybe you are the problem.

You’re killing me!

 

[MassWineGuy]

To Falcon: ???

FX Cares: To be safe, call them before your procedures.

 

[McFeely]

To Falcon: ???

FX Cares: To be safe, call them before your procedures.

Like I said earlier, who doesn’t even remember what/who he was talking about in other threads. Must be tough to be off your meds, Falcon.

 

[DeliveryException]

I got the test around that same time. I went to a FedEx sponsored location. They did it 2 days a week. One at FedEx Ground location and the other at Freight. I'm not sure if that is still going on or not. All I had to do was make appointment online and have my work ID when I got there.

I got the vaccine and just drivers license needed.

No cost or even mention of insurance for that matter.

 

[Cactus]

Like I said earlier, who doesn’t even remember what/who he was talking about in other threads. Must be tough to be off your meds, Falcon.

Falcon still remembers to take his idiot pills religiously.

 

[Star B]

First, it was because the correct procedure codes weren’t submitted. UHC contacted the provider who then sent the requested codes. That was about a month ago.

So.... did they deny it again? All I got was "I got a test, it got denied, found out it was because the pharmacy screwed up and billed incorrectly and i haven't heard anything since."

Sounds like it's working as intended. No bill from the pharmacy cuz it's covered.

and for as much as I hate insurance companies, can't blame them for denying something when it was billed incorrectly in the first place.

 

[NC man]

Just had colonoscopy two months ago, 2500 out of pocket,in network. Lovely.found couple polyps so changed to diagnostic.

 

[Operational needs]

Just had colonoscopy two months ago, 2500 out of pocket,in network. Lovely.found couple polyps so changed to diagnostic.

I thought a colonoscopy is preventative and covered in network.

 

[MassWineGuy]

It is, UNLESS they remove polyps. Then it becomes a procedure.

 

[Nolimitz]

It is, UNLESS they remove polyps. Then it becomes a procedure.

should still be covered. I had 11 polyps removed (under my wife's insurance) $0

 

[falcon back]

should still be covered. I had 11 polyps removed (under my wife's insurance) $0

All depends on how the doctors office codes it. Sometime when they find polyps, insurance will pay that one as preventative and every time after that as a procedure. Ran into that myself.

 

[McFeely]

My last medical bill. In network (thus the discount I guess), but we don’t want to cover cancer biopsies.

 

[vantexan]

When I had a stent put in an artery in 2011 I had a follow up examination about 2 months later where they used the radioactive dye to check my artery. Insurance refused to pay for it and I got sent bill for $7000. I talked to insurance and they said they would review it. I believe it was Cigna. 3 months later they again refused to pay for it. I complained about it on this forum, saying exactly what happened, how it was a part of my treatment. Less than 2 weeks later they sent a letter to me saying they would pay it. It was going to cost them $1500 if I remember right.

 

[falcon back]

When I had a stent put in an artery in 2011 I had a follow up examination about 2 months later where they used the radioactive dye to check my artery. Insurance refused to pay for it and I got sent bill for $7000. I talked to insurance and they said they would review it. I believe it was Cigna. 3 months later they again refused to pay for it. I complained about it on this forum, saying exactly what happened, how it was a part of my treatment. Less than 2 weeks later they sent a letter to me saying they would pay it. It was going to cost them $1500 if I remember right.

I am sure Cigna, United Healthcare, Social Security, the IRS and many other agencies read this forum regularly. I just wish the city of Oakland leaders would read on here. My A's desperately need a new stadium. I don't feel safe from the time I get off the subway platform till the time I walk in that garbage dump stadium.

 

[MassWineGuy]

My last medical bill. In network (thus the discount I guess), but we don’t want to cover cancer biopsies.


View attachment 337314

Appeal it multiple times. Don’t pay.