Complaint / review text:
My company switched to United Healthcare last July with a $1500.00 deductible and $3000.00 family deductible for a plan year and 100% coverage after that. On November 6th, 2008 my 17 year old daughter was diagnosed with cancer.
I was billed for the whole $3000.00 deductible for her and then after that deductible was meet they paid a few claims at 100% and the rest @ 50%. When I contacted UHC they informed me that they had a lot of new people and they entered the wrong code they would have it corrected in 48 hours.in January I started getting letters from lawyers saying that the hospital bills still havent been paid after I was assured by UHC that they were going to pay them in December.in trying to fix that error they decided to charge me $6000.00 in deductibles and they were un able to explain how that got on my account and informed me that they were going to audit my whole account and give them 15 days.
On March 2nd they completed my audit, still not fixing the claims and then wiping out my entire deductible. When I called I was told quote "oops we sent it to the wrong department and they entered a code for calendar year deductible and not plan year they would have to fix that and re-audit my account again for the claims they missed on the first audit. I have been calling everyday and finally on the 19th of May, they completed the 2nd audit, again wiping out my deductible and missing the claims that they ran through at 50%. The rapid resolution specialist informed me that I have a 50% co-pay for infertility services and that keeps getting entered by mistake.
She has cancer not trying to get pregnant. After speaking with the hospital today they still not have received the money owed since November 2007 and I have not received a re-imbursement check as promised for all the prescriptions I had to pay due to their mistake. I can not get a hold of anyone at the health care commissioners in maryland and finally got the attorney general today. My credit is going bad because I do not have the $200,000.00 in bills that the hospital needs because UHC made a mistake and has promised to pay.
I am told by a lawyer that I can not sue UHC for all my time and trouble because they have certain laws protecting them. I pay my premium every month on time and I expect them to pay for the services I am paying for. They keep resubmitting claims now up to over 20 times for some claims. The people I talk to on the phone do not understand why they are not paid and I am not sure either.
Does UHC pay people to make mistakes on people's claims hoping that they will go away? My daughter is now not able to get her treatments at the oncology clinic do to the bills not being paid. This has been since 8 months now trying to get this corrected. My daughter's life it as risk because of this company.
I have more important things to worry about right now then to sit on the phone with them for 5 -6 hours a day. I am going crazy and can not sleep trying to find ways to pay these bills myself until they finally pay for her to be able to continue her treatments. Does anyone know of anything that I can do? Is there any fast help?
I am begging anybody with any suggestions to let me know.