Monday, February 16, 2009

United Health Care...United Health Care.. How Doth Thou Sucketh? Let Me Count the Ways...

Okay as you can tell by my last post I do not have a whole lot of faith in anything anyone at UHC has to say. I really hate to have bummer entries, but this may be one of them, so if you're having a somewhat good day, move on. Or stay and laugh at the idiocy I've endured since last Thursday. I don't know where to begin so I'll do my best to get everything in.

I recently has a physical and during said physical A lump was found in my neck. My doc, knowing family history, said to be safe I should have  CT Scan. Well, the lunacy I have encountered can only be compared to.... well I don't know. You decide...
I am told the office staff had to gain a pre-cert so I could have this done and would call me in a day or so. Well, that day, only an hour or so later, Lisa calls from my docs office.
"'Tis Himself."
"This is Lisa. We have a small problem. Your insurance company is claiming you are not a member."
"Yeah I know. We just want you to be aware...this may take us a little while."
Knowing this is not her fault I say "okay. Let me know when you get it."
She apologizes and hangs up.
For kicks I call and ask the pinhead who gets my call to verify I am a member. He says "of course you are."
"Then why is someone in your company telling my doctors office I am not?"
He, of course, blames my doctors office. "They must be doing something wrong. Have them try again."
"Sure." Fuckstick. I call my docs office and not only does UHC still not believe I am a member ( I have a card with my name on it and everything.) they are still refusing my pre-cert. 
I see the office staff the next day and they are apologetic. "We had to fax everything over to them including a copy of your membercard and some of your DNA and a fecal sample. But we'll get it done." It did take three days.
Several days later they call and gave me a pre-cert#. I thanked them and on Thursday, the day before my CT Scan; Mags got a letter from a place called CareCore. It was the info and pre-cert for my CTScan. Apparently CareCore handles all the precertifications for ( MRI's,CT Scans, ordering jello-cups and bicycle helmets for the staff at UHC....) Not only was Mag's name on it instead of mine, the authorization number was totally different. I called UHC and they told me they had no record of any number or pre-cert at all. I went through the whole routine and finally the cock-knocker who took my call said "I will put you in touch with CareCore." So I was 'transferred' to the company that had closed their phones an hour and a half earlier.  I immediately called UHC back and got a blonde ( I knew she was blonde..sometimes you can just tell) named Alicia.
This half-wit also told me that there was no such info in the system but I should relax because I didn't even need a pre-cert for a CTScan. Anyone with eight or more functioning brain-cells will tell you you certainly do. Heck the cat laughed at me when he heard me say 'what? I don't need a pre-cert?' The radiology place wouldn't do the procedure without a pre-cert. 
So long story short, Alicia was as helpful as an electric bathing suit.
Next morning I call CareCore and get the info straightened out. I am told to go ahead and have the test done. I explain to who I can only guess was a little, 75 year old southern black grandmother, that I cancelled.  She was as sweet as I am short and she got very serious, "Honey you need this done. This is important."
"Yes ma'am. I had to cancel because the ass-cracks at UHC told me it hadn't been approved."
"Hrrmph..I don't know why they do that. You are all set. Go have your test done."
"Yes ma'am."
In the mean time , Radiology group calls and says that, yes, it has been approved and I can come in in one hour. Sadly, I have broken the fasting deal and cannot. She reschedules me for today. 
Ordeal over right? Hah!
I am filling out my paperwork this morning and the receptionist calls me over and hands me the phone??
Apparently it is CareCore wanting to tell me my procedure was approved to be done at the hospital, and not in the radiology building. It may not be covered..blahblah...I may have turned white but when I said "What??" the receptionist looked and me and smiled "They do this to us alll the time. 80% of the time we have problems with them. You'll be covered."
I 'approve' my test to be done in the 'radiology' building and finally, finally get my test done.
And by the way, UHC has told us that the docs we are seeing aren't in network....super huh?


sarala said...

I'm a doctor. We hate UHC too. I hope Obama works on some of this kind of health care reform too!

Jud said...

We had them at Brand X where I work. Wifey had a total hysterectomny and then wanted to send her home even though the doc said it was too soon and he thought she was getting an infection. No dice, insurance shipped her out. Within 28 hours my wife had a 104 degree temp and we were admitted via the ER to the same hospital. UHC wanted me to pay and ER bill and another $250 copay for another hospital stay. I asked the case worker if she had the room number where my wife was. S/he said yes. I then said if they ever wanted to see a nickel of the money they were gonna charge for these two incidents because they sent Wifey home too soon, they could come down and try to beat it out of me, otherwise I wasn't gonna pay. I ended up getting the person at Brand X who managed the plan to call UHC and work something out before it got much more out of hand.

Good luck.