Anyone have United Healthcare? (long;)

[browneyes]

Have you received SEVERAL explanation of benefits stating someone has tried to bill your insurance id for services rendered? Some doctor's office in Stateboro, Georgia is going to get an irrate call on Monday. I've received 4 explanation of benefits regarding this dr's office. Received them since my work insurance changed July 1st. I've called my insurance company 4 times now and they finally got sick of hearing me whine and gave me the dr's office number to get it straightened out.

My SIL thinks the person they're trying to bill to might've had my insurance ID prior to July 1. The insurance company told me the last time that was impossible rolleyes: ), that it was a little weirder than that. The person billed that time was a child with my ds's exact date of birth and same last name as my ds. Weird.

Anyone else have this kind of problem with United or am I the only special crazy: ) one out there?

 

[goin2disneyagain]

I have United Healthcare but I have not had any problems. Hope you get it all straightened out soon.

 

[piglet too]

I have United Healthcare and could write a small book on the problems we have with them. Have not had the problem you are having, but many, many others. The biggest one is that they have my DH's birthday wrong (they transposed two numbers) and the spelling on my name wrong. Our prescriptions often get denied and initaly some claims are denied as well. The problem I am facing right now is with a radiologist bill. I was in the ER of an approved hospital and had to have u/s and ct scans. They are not paying the radiologists because he is not on contract with them. Yet I was at a hospital that is? Don't quite get how that works and don't think I should be stuck with the bill when I had no choice in the matter. I know this will be an issue with my surgical bills as the anesthiologist (sp) are not on contract as well.

 

[tar heel]

We're on our second time around with them. The corporation my dh works for keeps switching companies.

We've had a few problems with them, too. I'm currently paying $50 a month for a $1,000+ bill that wasn't covered -- pretty much the same situation as piglet too's. My dh went to a pain clinic that is part of our plan where he saw a doctor that was not part of the plan. We had no idea until we got the bill. Since the clinic was in the plan, asking didn't seem necessary.

We actually rarely get Explanation of Benefits forms, even when we should.

We are getting lots of bills from providers for the part the insurance didn't pay. My understanding is that we don't have to pay those b/c the provider's contract with UH is for that amount, but dh just paid one of them when he went to see his doctor.

 

[browneyes]

I'm glad you're not having problems with them, goin2disneyagain.

Piglet too, I'd be really irate if I was in your shoes. It sounds like you have my luck! I haven't even used my insurance yet other than to get my SO's Prevacid rx renewed. I didn't have problems there, but that's because I was expecting to have problems (I think I jinxed myself out of problems by preparing myself to battle). I hope they get your stuff straightened out soon.

Tar heel, do you go online to check to see if they have your explanation of benefits correct there? I hope they get straightened out on your stuff soon too.

The first 2 times, the insurance company just told me to throw the statements away. I don't know what happened to the first one, but I've kept the other ones where I could reference them. Time before last when I talked to them, they told me nothing would be on my insurance information about any of this. But when I called today, she said it showed up that this doctor was trying to bill someone not on my insurance. The way she phrased it, kinda made my temper flare up a bit. I told her this patient owes this dr over $13,000 on this one bill alone. The other ones have been a couple of thousand dollars also. I'd like to know why and how this dr has my id number. And why they haven't noticed it's the wrong person yet. Someone has some costly medical bills and if it's a typo, and if it's the same person, they must be pretty frustrated right now wondering what's going on with the insurance.

 

[Pin Wizard]

piglet too...That happens a lot believe it or not. I worked at a hospital 8 years, and the anesthesiologists were not on my insurance plan! And then when the hospital changed ER groups... What a mess! But luckily, as an employee, they wrote off a good amount of it.

Shannon...Any chance this doctor could have been your son's doc at some point? Maybe he left your area and went somewhere else with the records. I found two different docs in FL had another patient with my name. And my OB's office for a couple months had a problem with it. When I received a message on my answering machine that my pap was fine I thought...that was almost a year ago! Now they call? Then I received an Explanation of Benefits (EOB) from the insurance company. I wasn't at the doc's office anywhere near the date they had as the date of service! Somehow or other two and two were put together. I called the OB's office and told them I wasn't there and I had run into another person with my name at my dermatologist's office. The lady asked if my address was whatever she had on file. I told her NO! Sure enough, they must have somehow billed the wrong insurance company. I told her she better physically pull the chart and make sure they didn't enter all of that person's stuff in MY chart!!! That's a major screw up if they do things like this. Good luck getting it straightened out!!

 

[dcg0317]

The company I work for use to have UH but was having to many complants, so this year they dropped them and we now have a different ins. We actualy had three ti choose from.

 

[pirateofthecarolinas]

We have UH, but haven't had any problems. The only complaint I have is the amount of drs. that are either dropping UH or not on their plan. We keep having to find new drs. Very frustrating.

Lori

 

[TheOtherVillainess]

We also have UH and there are times I know DH wishes we didn't. We battled for MONTHS with UH and the plastic surgeon who did the digit removal on DS. UH didn't want to pay for certain things and so the dr was using that as an excuse to try and charge us an arm and a leg.

The surgeon has priveleges and an office at a hospital. He also has his own private practice outside the hospital. The hospital office and the private practice have th e same tax ID apparently. When we got our EOB for DS's extra digit removal surgery, they attempted to tell us we were seen at the dr's private practice. We've never been there. We battled with the insurance for weeks over that and DH got extremely frustrated.

We also had a few problems with them when I gave birth to DS, as our insurance switched from a deductible to a $20 co-pay because it switched over on the same day DS was born.


*edited because I forgot to add--
When I had my sonogram, the hospital (which is listed in the provider list or whatever)sent the sonogram out to be read by somebody. That somebody was not on the list and UH tried to bill us for it. WE didn't choose who read the sonogram, the hospital just sent it out. So we had to spend many hours fixing that.

Also..my ob/gyn wanted to kick them soundly in the teeth when she prescribed wellbutrin XL for me. They didn't want to cover it without her calling them and explaining why I needed it first. Morons.*
TOV

 

[The Mystery Machine]

We have UH and don't have any issues here but I will say we had the "billing issue" from a prior insurance problem once.

A lab incorrectly billed our old insurance which was no longer valid. No biggie, right? Well they didn't TELL US until 3 yrs later, a message from collections shows up in the mail...WHAA??

We paid it. Too much headache to fight it.

Bottom line check all your visits to make sure they are getting paid. Sorry...& good luck.

 

[DisneyDmbNut]

I had UHC till this year ( it was WAY too expensive here in Florida ) and never had a problem with them..what concerns me is that your member # is your Social Security #...with 01 for subscriber 02 for the second person ( In my case, my daughter is xxx-xx-xxxx-02.
It might not be a big deal..but if they have the wrong subsrriber #, then they have you SS#

 

[tar heel]

DisneyDmbNut -- Actually, they probably don't have her ss#. Our United Healthcare number is NOT dh's ss#. That is one good thing I can say about UHC!

 

[EsmeraldaX]

We can pick from about 5 different HMOs and other health plans through my work. We used to have Tufts, then Blue Cross THEN Harvard Pilgrim.

Harvard Pilgrim was the worst. Now we've moved on to United, hoping they would be better. So far, no problems. They have been great.

I'm sorry you are having problems. But I have found United's customer service line to be really helpful. I'd give them a call and maybe ask for a manager.

 

[binny]

We have UHC and so far so good SUCH an improvement over the Healthscope we had until this year. YIKES they were terrible!! This UHC plan covers almost everything with no deductible as long as we stay in plan and that happens to be a lot here. Im very happy with that!

 

[Aimeedyan]

Sorry you're having such problems!!!

We have had United for awhile now, and amazingly enough, they've been excellent so far - and we've used them ALOT. They have yet to deny any of my claims, and have ok'ed my super expensive infusions with no problems.

Crossing my fingers it stays that way!

 

[Serena]

I have it too, but I haven't had it for long. So far no problems.

I hope you get it worked out.

 

[kidzmom3]

I am the supervisor for Access Services at a medium sized community hospital. This is my opinion of why this is happening to you with your unitedhealthcare. United healthcare and all insurance companies have websites that professionals use to verify insurances, get referrals and submit claims. When a patient presents themselves without their card, but state they have (in your example) united healthcare. We log onto the website and do an Alpha search using name and DOB to obtain the patients policy number. It sounds like someone in that drs office was careless and just picked the first person with that name and dob, and did not verify the address information. This should be a relatively easy thing to fix, the office just needs to take your id number of the other patients chart, find the right number and resubmit the claims.

 

[browneyes]

Originally posted by Pin Wizard
Shannon...Any chance this doctor could have been your son's doc at some point?

Nope. This dr is about 450-500 miles from me.

 

[Pin Wizard]

Oh, well! It was a shot in the dark. That is too strange.

 

[browneyes]

Originally posted by kidzmom3
I am the supervisor for Access Services at a medium sized community hospital. This is my opinion of why this is happening to you with your unitedhealthcare. United healthcare and all insurance companies have websites that professionals use to verify insurances, get referrals and submit claims. When a patient presents themselves without their card, but state they have (in your example) united healthcare. We log onto the website and do an Alpha search using name and DOB to obtain the patients policy number. It sounds like someone in that drs office was careless and just picked the first person with that name and dob, and did not verify the address information. This should be a relatively easy thing to fix, the office just needs to take your id number of the other patients chart, find the right number and resubmit the claims.

Thanks kidzmom3. The 3rd time I called my insurance company they said they thought that maybe the hospital that keyed in the information probably did a search on last name and DOB and didn't check to verify any of the other information. I haven't had a chance to call the dr's office (I've been out of town), but they'll hear from me today.