United Health Care

Reviewers
Male / Female		 Recommend
Yes / No		 Number of Reviews Coverage Claims Customer Service Cost Total Average Rating
1 / 2 0 / 3 3 3.00 2.33 2.00 3.33 2.67

Date Submitted: July 1, 2010
Insurance Provider: United Health Care in California
Coverage: 1 out of 10
Claims: 1 out of 10
Customer Service: 1 out of 10
Cost: 4 out of 10
Recommend: No
Review: United Healthcare's Questionable Tactics
I just read an article that says, “Hospital executives rank United Healthcare as the worst insurance company in the United States.” (It is available here: www.allbusiness.com/health-care/health-care-facilities). This will come as no surprise to many members and providers alike. Like many others, I want to share my recent experience with United Health Care so that people can decide for themselves whether or not this is the kind of health insurance they feel they want to purchase for their families.

I am a neuropsychologist and was asked to see a UHC member for neuropsychological testing. I filled out all of the appropriate forms required by United Healthcare and received a telephone call authorizing me to test their member. They gave me a cap on the hours (13 hours total) and an authorization number. I provided the services as promised and then sent the appropriate claim to the United Healthcare offices. When they sent me the check, there was a note on the Explanation of Benefits saying I had agreed to a discounted fee (an approximately 50% discount, mind you) through an organization called MultiPlan (If you haven't heard of them, you're in for a treat. They contract with insurance companies to try to persuade clinicians to agree to a reduced fee and they get paid a percentage of what they "save" the insurance company.) Needless to say, I do not and never will have an agreement with this company, as I do not support business practices such as this.

When I contacted United Healthcare to straighten this out, they told me I had to deal with MultiPlan. Multiplan never answers their phone (I wonder why) so I got nowhere until I filed a complaint with the Better Business Bureau. This got the attention of Cindy Hernandez, a Consumer Affairs Advocate for UHC (1-800-842-2656). She researched this issue and came up with a fabulous solution! She decided that United Healthcare had authorized this treatment in error and paid me in error AFTER I HAD RENDERED THE AUTHORIZED TREATMENT to their member. They then "recalculated" the claim form and decided that I actually owe THEM money! They have asked for the entire amount back ($966.68). They have a very fancy way of explaining their "logic" and have added that the original error was with their processor and they have arranged for her "to receive additional training or other intervention as appropriate."

With a second patient, they attempted to get me to accept a reduced fee through MultiPlan for another member and I declined. After that, they refused to pay me AT ALL for the services I provided to the other member while he was in the hospital. United Healthcare also authorized these services and the correct authorization number was submitted with the claims.

In both cases the services were requested by a physician and approved by United Healthcare. The services were rendered as authorized and the appropriate claims were filed. Unfortunately – and this really is the sad part – both of these claims will have to be paid in full by the members. These claims total thousands of dollars.

As I'm sure many of you know, United Healthcare is the focus of a Class Action Lawsuit in New York because of their questionable business practices. When I Googled “United Health Care reviews,” I was SHOCKED at the number of complaints against this company. How is it that they are getting away with this kind of behavior?

Comments [ 0 ]
Submitted by: nah415
37 year-old   ::   Female Reviewer   ::   California

Date Submitted: May 21, 2009
Insurance Provider: United Health Care in California
Coverage: 3 out of 10
Claims: 1 out of 10
Customer Service: 1 out of 10
Cost: 3 out of 10
Recommend: No
Review: It's not worth it!
United HealthCare is notorious for their customer services. If you are put on hold or transferred to another extension, expect 3/5 times you will be disconnected and nobody will follow up. The phone is always directed to voicemail. I sometimes wonder do they just hire some part-time or housewives to work for their customer service. Since they are infamous for unresonablely rejecting doctor's claim and poor reimbursement, most doctors do not accept United HealthCare insurance. As such, even you have their insurance, it's no use if you cannot follow the doctors that you like. I ended up changing my insurance to other companies. Overall, the experience is BAD.
Comments [ 0 ]
Submitted by: Frustrated Patient
34 year-old   ::   Female Reviewer   ::   Pasadena, CA

Date Submitted: November 1, 2007
Insurance Provider: United Health Care in California
Coverage: 5 out of 10
Claims: 5 out of 10
Customer Service: 4 out of 10
Cost: 3 out of 10
Recommend: No
Review: Headaches, frustration, with some silver linings.
I pay a lot to be in their Definity Gold plan (the best my company offers) which requires that you use doctors, Labs, and hospitals in their preferred provider list or you pay an additional 20% out of pocket and anything that is above their payment for in network providers. They had a reasonable list of doctors in their preferred list. Since they were purchased by Pacific Care they are reducing their payments for service and we are getting letters from our doctors that they can no longer accept their coverage. If you go to a doctor who is in their list or was in their list their list last time you went to the doctor there is no guarantee that they would be dropped from the list while you’re driving to your appointment. My Family has been bit twice this year by that. If your lab work isn’t sent to a lab on their list you pay the penalty. You can get an out of network exception supposedly if they have no provider in network within 30 miles of you. But, if they have a provider on their list even if they don’t exist or don’t do what it is you need you’re screwed. I wasted a day and a half on the phone with them trying to get this done and they lost all five (5) requests that they entered in their system. If the condition is serious or an emergency it will not get done and you’ll be the one paying. I am trying to get an out of network exception for something that is not immediately life threatening. It’s taken three weeks and they agreed to pay the doctor (whatever that means) but they lost the part about the device the doctor is fitting to me and we are resubmitting. They do pay about 80% of the time without all the hassles. But they are slow. So if your time has no value at all. This might not be a problem. The silver lining is. They do have nurses you can call any time of the day or night for advise and if you have major surgery a nurse is assigned to you who reviews what the doctor has done and is planning and our nurse actually suggested requesting Physical Therapy., and has given good suggestions on fighting the bureaucracy of trying to get a bill paid.
Comments [ 0 ]
Submitted by: Roper
50 year-old   ::   Male Reviewer   ::   Orange County