comment to review:

Unable to get my money back

United Healthcare #1146600
Happens to me all the time. OptumRx Sucks big time. Talk to a Healthcare Advocate from UHC and get them to do the talking for you.
Hope that helps
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comment to review:

Autopay issues/coverage termination non stop

United Healthcare #1146598
Go to Goodrx, Needymeds, or Blink to find a coupon for your script. If it is something routine like a blood pressure med or something, its gong to be really cheap. They are all better than the cash price the pharmacy is offering.
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comment to review:

Acute Mental Health Referral

United Healthcare #1146596
I find a physician I want and then see if they are in network. Dr. Referrals are better than insurance because their records are updated maybe every 4 years.
Ask your doctor to refer you to the psychologist/psychiatrist they would like you to see and then submit the paperwork.
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comment to review:

Can't fix problem they made

United Healthcare #1146595
Unfortunately, this is why a paper trail is so important. I bet someone didn't record the information in the computer about the call...which is very slick. Have them go through all their records showing who was in network and who wasn't. You should speak to a healthcare advocate. If that does not work, you can contact the healthcare advocate for your state and they will get things done.
On the statements you received, you should see who the coverage was for...same thing on the ID cards.
Hope that helps...and know what...if they take you to collections, tell them you are disputing the charges and ask them to prove that you are still responsible.
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comment to review:

Electronic Referral vs Referral

United Healthcare #1146594
Appeal it.
That is not a reason to deny it.
However, they may be able to backdate the electronic referral and have them reprocess it.
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1 reply
Anonymous
#1485690
Oh...they can get it covered because their PCP in the UHC programs does not know they HAVE TO electronically send it to the referral doctor. They need to train their providers. They handing me a printed referral and I had to train them. UHC is a joke. Be careful
comment to review:

United Healthcare Ppo Health Insurance Review

United Healthcare #1146593
Something you may be able to try is a gap exception...where the doc submits a preauthorization to use that doctor because there is no other qualified physician within 30 miles that can do the procedure.
This may require some digging, but if their in network doc is not board certified or cannot treat your condition, that may be grounds for a gap. However, these are very tricky. All variables must be accounted for... Procedure codes, Diagnosis Codes, etc. If it is not, they will deny the claim.
The alternative, is to use out of network benefits. Sometimes if you see a PA, it can be coded under an attending who is in network...which is not considered fraud because PAs work under a supervising physician.
I hope that helps
Btw, a PPO should allow you to see whatever provider you want. Its called a Preferred Provider Organization (your preference).
You may ask the doctors billing office to see if they can get the doctor signed on to be in network for United under your plan.
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comment to review:

United Healthcare - Health Insurance Review from Arvada, Colorado

United Healthcare #1146588
I wish I was there to help you.
What was the reason for the denial? It is possible that the doc's office rushed. However, United can lose forms sometimes...it has happened before. I would be just as pissed as your are...I understand your pain because I am a pain patient too...Myofascial Pain Syndrome.
There is something called a Peer to Peer Review which allows another doctor in the same specialty to evaluate your chart and see if that procedure is medically necessary.
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