Complaint / review text:
I am on medicare and have a med Advantage plan with UHC. For the last year, since my doctor joined a larger health group, things seem to be messed up. I originally blamed the "new" office help but have recently found the problem. My original Primary Care Physician took 6 months off and another doctor took over for him. When I started receiving bills from the doctor's office for things that should be covered, I called the office and was told the bill wasn't paid because I didn't use my primary care physician (PCP). I had my explanation of benefits in my hand at the time and it said the doctor was out of network. It seems UHC doesn't use the same explanation of non benefits for the doctor as for the patient.
I called UHC and they told me the doctor was out of network. I said, "I have your BRAND new booklet here in my hand that says he is in network." I was put on hold for about 15 minutes. They came back and said my doctor has 2 numbers and the number he used for my claim was the out of network number??? I talked to the doctor's office and was told ALL claims are submitted with his current number and he retired several years ago from an office in a different city and UHC must still have that number on file and are using it for his claims. Now I am 3 months behind with unpaid bills and still can't get UHC to admit their screw up. Evidently it isn't a screw up, just a SCAM to get out of paying out what is owed.