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  1. #1
    Join Date
    Nov 2005
    Posts
    3

    united healthcare UHC denial of coverage

    UHC does not provide a single way to email them. They have phone numbers with options that disconnect you. They send you letters that have phone numbers in it that are disconnected. They use a tactic called "gaslighting" where they transfer you back and forth until you give up. I was denied a doctor prescribed procedure on the basis that there was not enough data to support the procedure. Then when I spent 100's of hours pursuing an appeal and threatened an IRO ( independant review organization) by the state insurance department, they miracously approved my procedure by telling me they had misread my policy and I was covered. The problem was they denied it because they said it was not a proven procedure not that I was not covered for it. When I got evidence of them covering the procedure for others, threatened legal action, requested copies of all documents in my case and relied upon when making their ruling, asked them to tell me if they had ever covered the procedure and threatened an IRO they crumbled. The fact is they were trying to delay and deter me as long as possible with the hope that I would just go away. At least that is what it appeared to me they were doing. Other websites called my attention to it and told me what to do and it worked. Be vigilant with your health care companies. They will do everything possible to make approval for a benefit impossible. You will spend 100's of hours on the phone with them. But if you need the procedure, like I did, in order to live a quality life, it is worth it to push them like you have never pushed anyone before. I could go on and on about the tactics they employ, just know you have to keep on them and play tough.

  2. #2
    Join Date
    Oct 2005
    Posts
    97

    Re: united healthcare UHC denial of coverage

    Sometimes its not just the insurance company pulling these tactics. If you have more than one insurance carrier they will deny by claiming the other one has to pay first. Things can get real nasty then.

    I'm glad you stuck with it and got the care you needed.

  3. #3
    Join Date
    Oct 2005
    Posts
    96

    Re: united healthcare UHC denial of coverage

    Quote Originally Posted by kmmaris
    UHC does not provide a single way to email them. They have phone numbers with options that disconnect you. They send you letters that have phone numbers in it that are disconnected. They use a tactic called "gaslighting" where they transfer you back and forth until you give up. I was denied a doctor prescribed procedure on the basis that there was not enough data to support the procedure. Then when I spent 100's of hours pursuing an appeal and threatened an IRO ( independant review organization) by the state insurance department, they miracously approved my procedure by telling me they had misread my policy and I was covered. The problem was they denied it because they said it was not a proven procedure not that I was not covered for it. When I got evidence of them covering the procedure for others, threatened legal action, requested copies of all documents in my case and relied upon when making their ruling, asked them to tell me if they had ever covered the procedure and threatened an IRO they crumbled. The fact is they were trying to delay and deter me as long as possible with the hope that I would just go away. At least that is what it appeared to me they were doing. Other websites called my attention to it and told me what to do and it worked. Be vigilant with your health care companies. They will do everything possible to make approval for a benefit impossible. You will spend 100's of hours on the phone with them. But if you need the procedure, like I did, in order to live a quality life, it is worth it to push them like you have never pushed anyone before. I could go on and on about the tactics they employ, just know you have to keep on them and play tough.
    DONT EVEN GET ME STARTED ........ I HATE INS CO.'s ............... The yave people with very little medical background .. looking up informatin in their data base to determine wheather or not a particular procedure is " medically necessary .... " ..... dont even get me started .......... GLAD YOU STUCK TO YOUR GUNS !!!

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