Friday, March 25

Not happy, thanks to UHC

Usually, I'm happy.  All six of us in our home have health insurance.  And we have access to quality medical care.  For that I'm happy and grateful.  But recently, when we needed some education and awareness around substance abuse issues, and I entered a parallel universe.  The behavioral health, health insurance parallel universe (cue in music from Twilight Zone and layer over one really tired and frustrated mamma bear).

It all started back in October.   We pre-approved with our insurance so we get into a local outpatient treatment provider.  Pre-approved.  This means we had a long conversation with our insurance company United Healthcare and then with HMA and all seemed fine.  Yes you have benefits.  Oh, yes you have a need.  Yes, you can see that provider, here let me note that in your file and send you a letter at home that says you are approved for treatment and we will provide x benefits.

Fork over CASH to the provider because they haven't dealt with United Healthcare and aren't sure how the claim processing will happen.  Hmpf.  Well, UHC says we are preapproved for this treatment and you are the provider we can use (insert me looking like Snow White here, all innocent as the driven snow).

Twelve weeks of outpatient treatment pass, SUCCESFULLY (praise God), and I'm talking to the provider's billing clerk and the claims just haven't been processed by UHC.  Hmpf.  Wonder why?  And gee whiz I'd like my cash back at some point.  I'll call them (insert me looking like June Beaver, all organized and tidy with my notepad)  .... MANY times.  Tracking reference numbers, answered questions, looked up the provider taxID, license status, address, phone and fax.... thinking I was answering UHC's questions to process the claims.

I, apparently now, have been chasing my tail and buying time with UHC.

Today's phone call, after the provider called and I called supplying repetitively the same information went like this.  Well, we at UHC have SO MANY claims we ship them off-shore to be processed and depending on workloads it could take 30 days after each new piece of information, you supply, to come up with additional questions and problems with the claims.  We are so sorry.  See there are SO MANY claims they are done now by outsourcing to India.  Hmpf. 

And after answering a few more questions today, which have been answered repetitively before by me and the provider, the customer service person shared with me that she has been downsized from UHC offices into her own home (after I heard a dog barking on the phone, again cue Twilight Zone music) because the company has decided working with staff in India is cheaper than hiring and keeping incredibly personal confidential health insurance local.   I lost it.  Asked for her to mark the issue "expedited" for approximately the 12th time and said I know that nothing I ask ... or say... or answer.... or pray... that these claims will never be paid by UHC.  It's a losing battle on getting the services paid for.  I'm angry, defeated and really upset.  They are such a beheameth. 

Looking on the brightside.... the services we got thru the local provider were EXCEPTIONAL and we are back on track as a family.  Because we are a tight family.  Albeight the expensive track.  The track that focuses on walks to see the beaver after dinner, watching movies all six of us squished onto the couch, late night talks, sharing dreams for the future and just being comfortable with us as us.  Urgh, UHC you won't be thought about for another 30 day period!   

Tommy Adventures