Looks Like UnitedHealth Has Been Naughty

My experience was their right hand had no idea what their left was doing nor did it care , calls are out sourced and not always easy to understand , a huge disaster in many ways and I am lucky as no health issues but the one time I used them just a failure so dropped them and embarrassed ever used them.

Would be interested in others experiences .
 
There are so many factors in health insurance worked in the industry for years.
It is all a mess. billing issues IMO are NOT all insurance fault but the codes used by those billing the insurance company.

My worst issues I have to resolve were NOT on the insurance companies but billing errors on the medical offices/ hospitals etc. It is ironic that no one seems to blame them.......

I went to an ER was billed by dr/ hospital /labs/ xray etc out of five different billing groups.........
ONE billing out of 5 billing groups ....... Reversed my address and insurance # ..... never sent to Insurance ..... and when it came back from mail being wrong.... BILLER sent to collection instead of calling or referring back to hospital record which was correct.......then the BILLING blamed ME that i gave wrong info at admission !!! TOLD they that was a lie as the other 4 billing groups had zero issue
Then asked why they did not call they did not screw up my phone # they said they worked remote and could only take calls NOT make them.

I always check the billing group first instead of the insurance ........one code off or incorrect info will get rejected ... i have turned in 2 these independent billing groups to every agency i could and the BBB . My insurance which was UHC at time fixed it all for me.
 
Jeni said:
There are so many factors in health insurance worked in the industry for years.
It is all a mess. billing issues IMO are NOT all insurance fault but the codes used by those billing the insurance company.

My worst issues I have to resolve were NOT on the insurance companies but billing errors on the medical offices/ hospitals etc. It is ironic that no one seems to blame them.......

I went to an ER was billed by dr/ hospital /labs/ xray etc out of five different billing groups.........
ONE billing out of 5 billing groups ....... Reversed my address and insurance # ..... never sent to Insurance ..... and when it came back from mail being wrong.... BILLER sent to collection instead of calling or referring back to hospital record which was correct.......then the BILLING blamed ME that i gave wrong info at admission !!! TOLD they that was a lie as the other 4 billing groups had zero issue
Then asked why they did not call they did not screw up my phone # they said they worked remote and could only take calls NOT make them.

I always check the billing group first instead of the insurance ........one code off or incorrect info will get rejected ... i have turned in 2 these independent billing groups to every agency i could and the BBB . My insurance which was UHC at time fixed it all for me.
Click to expand...

I've had problems like that with billing too. My wife and I have Medicare as primary and BCBS as secondary. On several occasions the provider or the billing service has billed BCBS first. Then of course BCBS rejects it because they are secondary. I have to check every bill I get to make sure it has been billed properly and they have gotten as much as they can from both of my insurances before I will pay them.

One provider screwed up so bad they kept billing BCBS first for over a year which missed the deadline for billing Medicare. They are still trying to get me to pay the whole bill. As far as I am concerned that's their problem. They are the ones that screwed the pooch. I pay over a grand a month out of my pocket to for both insurances and I'll be damned if I'm going to pay some provider more out of my pocket because they failed to bill correctly.
 
I have an advantage plan now, but in 2023, I had Medicare and a supplement. That year, Medicare paid 4 fraudulent claims for a glucose monitor. Even though I saw the first fraudulent claim on my Medicare EOB statement and notified them promptly, they still went on to pay 3 more similar claims from the same company over the next 3 months. I'm not diabetic and never ordered or received the glucose monitors.
 
MACKTEXAS said:
I have an advantage plan now, but in 2023, I had Medicare and a supplement. That year,

Malcolm Gladwell ponders if Miami itself is to blame for being the U.S. fraud capital​

paid 4 fraudulent claims for a glucose monitor. Even though I saw the first fraudulent claim on my Medicare EOB statement and notified them promptly, they still went on to pay 3 more similar claims from the same company over the next 3 months. I'm not diabetic and never ordered or received the glucose monitors.
Click to expand...
I'm in Miami and can tell you stories from countless I know you would not believe and sadly you are correct as far as Medicare paying even after they know it is a scam .

''Malcolm Gladwell ponders if Miami itself is to blame for being the U.S. fraud capital''​


https://www.wlrn.org/business/2024-12-09/malcolm-gladwell-medicare-fraud-miami-tipping-point
 
A very old friend of mine after retiring as deputy DA, prosecuting district attorney took a PT job with the State Medicare Fraud Division, a newer endeavor at that time. (CA) You wouldn't believe how rampant the theft is, healthcare providers stealing from our Medicare system with fraudulent claims, double-billing, etc.

He even caught HIS OWN DOCTOR filing false claims and double billing for his own office visits! (That case was reassigned.)
 
I've had UH with my Medicare and have seen a lot of fraud involved with my care. I reported some things but, like with @MACKTEXAS, it doesn't seem to stop... I cynically assumed due to lack of interest on the part of Medicare... IDK, but I quit reporting things like that.

One doctor I had just continuously, had me in for test after test... mostly blood work thingies... that I didn't need. Like 3 Boston blood workups every year.
Another doctor routinely billed Medicare/UH for 2 (hour-long) procedures for a 15-minute med evaluation... every month. Again, Medicare didn't seem to care.
 
A neighbor tried getting me to join and swears by them because of all the freebies he gets. However I did a lot research, especially in Propublica and decided against it. I've read a lot of horror stories from people who were turned down for major procedures.
 
Oldeagle66 said:
A neighbor tried getting me to join and swears by them because of all the freebies he gets. However I did a lot research, especially in Propublica and decided against it. I've read a lot of horror stories from people who were turned down for major procedures.
Click to expand...
My sister has United Healthcare and found out after knee replacement surgery that it was hard to place her in a rehab facility because of her insurance. Both a nurse and social worker told her. She wound up getting therapy at home. I was part of a patient advisory counsel at my doctor's practice. Members were office staff, a nurse, a PA, the office manager and a few of us patients. When I mentioned the problem with UHC and getting patients into rehab, the nurse and office manager said their office had also experienced that problem.
 
Back when I worked for Humana, we were on the verge of merging (or being acquired) by United. The big joke was that the new company was going to be called Unhumane.

It was the "11th hour" in negotiations, to the point that the Humana logo (the winged figure "The Spirit of Service") had disappeared from the website. Oh, no, they've killed the fairy!!! we wailed.

There was also going to be a simultaneous announcement to all the market offices. I had to bus the entire office to a conference site where the announcement was to be beamed in via a television truck.

Everything fell apart literally at the last minute and the big announcement was literally "Everything's JUST FINE! JUST FINE! La-la-la. Everybody go back to work. Nothing to see here, folks. Keep moving..."

And we all pretended that nothing happened. The Fairy came home to roost. Business as usual. Lots and lots of $$$ wasted.

Your insurance at work....
 
And in today's news:

(Reuters) -UnitedHealth ( UNH ) shares fell more than 6% on Wednesday after the UK's Guardian newspaper reported that the company made secret payments to nursing homes to reduce hospital transfers, adding to the woes of the healthcare conglomerate.
 
I switched from United Health to Ambetter Health during open enrollment in December, after the incident of that CEO murder and all things exposed late last year. I don't know if Ambetter is any better, but I know I don't want to support United Health.
 
OldOld said:
I switched from United Health to Ambetter Health during open enrollment in December, after the incident of that CEO murder and all things exposed late last year. I don't know if Ambetter is any better, but I know I don't want to support United Health.
Click to expand...
Same with United airlines. I boycott United Airlines since the incident where they dragged the doctor out of the seat and dragged him on the floor out of the plane, just to make the seat available to their crew many years ago. Their CEO was so arrogant and made no apology until the public outcry.
I don't fly often but when I do, I do everything I can to avoid United.
 

Last edited:
You must log in or register to reply here.

Back
Top