[smoseley]

Ok, so we were switching insurance companies at my office and our OO screwed up and we all wound up with a lapse in coverage. Oops! So now my pre-existing conditions (epilepsy) aren't covered by insurance for a year. Oh well, the company is liable for it, not me.

But last October, I got bitten by one of my cats, and the bite got infected. I went and saw a doctor and they prescribed me penicillin. I had an allergic reaction, and had to see another doctor, who gave me some antihistamines and at the same time gave me a physical and did some routine bloodwork (cholesterol, liver, and what not).

Ok, well freaking SOB United Healthcare has held payment on that bill pending further information "because they believe the treatment may have been for a pre-existing condition." Meanwhile, I've got medical bills out the wazoo for this crap and collection agencies now on my ass?? WTF!?

My agent is nice enough about it, but powerless due to new HIPAA privacy laws, and WTF is with collection agencies ?!?

I realize what's going on, and I don't like it one bit. The insurance company realizes that it's not a pre-existing condition. The history of the claim and the specifics of the treatment would tell anyone that it's not. They're holding off intentionally so that I'll get scared of these collection notices and go pay the bill to avoid my credit being affected. It's f**king unreal. Does anyone know of any free service where I can make an official complaint about how United Healthcare is handling this thing? I'm livid about it.

 

[mikester]

In California, there is a state insurance bureau, that fields and investigates consumer complaints. Your state very likely has one as well. I'd start with that, if I were you. There's also the Better Business Bureau.

 

[rtking]

Transio, if you can... you might want to pay the bill. Most insurance companies have your social security number and they pass that along to bill collecting agencies.

The problem is that the insurance companies don't care that your credit is getting ruined... so you end-up having to absorb everything. It sucks... but if credit is important to you, it might be worth it. (Credit is crucial for me because refinancing as a self-employed, declared income applicant is already tough enough. Without decent credit, I can't refinance my house to pull-out money during the lean times.)

Bob

 

[smoseley]

My credit is very important to me. It's not, however, as important as making sure the insurance company fulfills its responsibility in this matter. If necessary, I'll take them to court and pay MORE than the bill to make them fulfill their responsibility.

If my credit gets ruined in the process, I'll sue for damages and make them straighten it out.

It's an unacceptable situation.

 

[babak]

United Health is notorious for this kind of behavior...they consistently delay their accounts payable to keep money on the books, specially near the end of the quarter to make their reports look good. When I was down in Tampa at times we had to resort to letter from our atty to make them budge and pay up. Bob is right here, your credit is at stake, and even though you'll eventually get it repaired during this time period it'll make life difficult. Most hospital billing systems will allow you to make minimal consistent payments, i.e. around $10/month, the constant inflow will keep your bill from being reported while you're dealing with the evil empire.
Good luck

 

[ivan1]

How about starting an ebay listing for a manual on how to deal with United Health Care???

 

[babak]

How about starting an ebay listing for a manual on how to deal with United Health Care???

A fellow comiserator, these guys are beyond evil, both to patients and providers.

 

[smoseley]

A fellow comiserator, these guys are beyond evil, both to patients and providers.

Yeah, I spoke to my physician today, and he agrees that United Healthcare's position in this matter is absurd. I mean, he gave me a routine physical and treated a cat bite, and they're asking for more information because "it may be a pre-existing condition." LMFAO !!!

 

[xxxotic]

Did you ever get bit by a cat before? Just Kidding UHC sucks.

We used to have $15 copay and now it is up to $50, and I have to take 4 presciptions a month since my cholestrol is about 400 and my triglycerides were about 1200. They can actually see the cloudiness in my blood when they take it. It would probably be cheaper to just have a heart attack and pay the $100 hospital co-pay then to have to pay $2400 a year for my medicine. My mother has lung cancer and she is paying about $1700 a month just for one prescription, but if she had chemo instead of the medicine, medicare would cover it, but then she would be sick all the time instead.

I got attacked by a friends dog and lost use of 10% of my hand. Those bastards at UHC attached a lien on my lawsuit so they could collect what the doctors normally charge instead of what they accept as normal payments for UHC participating doctors. And Allstate, another company that sucks and that is notorious for trying to setlle for less than what you are entitled to, tried to get me to settle out of court for about $5000 and my medicals bills were over that so I would have only wound up with nothing if I listened to them. Luckily my mother worked for a company that rates lawyers based on their skills and she got me hooked up with the highest rated one in town, so in the end I didnt wind up getting totally screwed, but then the lawyers get 30-40% of your setlement anyway.

Everybody tries to screw you when it comes to insurance. My homeowners insurance went from 900 a year to 1500 in 4 years without any claims. They say that it is because of the increased risks of hurricances. A tornado wiped out a bunch of houses across the street from me last year, so what are the odds of it happening again? But I can get a discount if I get a notarized letter from a certified building inspector stating that I have a "self-adhering polymer modified bitumen roofing underlayment or a foamed polyurethane adhesive that is applied to seal all joints in the sheathing to protect from interior water intrusion."

The also want to know if i have a hip or gable roof and want to know if the sheathing is attached to the roof trusses with 10D nails or #8 screws which are spread 6 inches on edge and 12 inches or less in then field or an AFG ahesive applied with an E or greater bead between the sheathing and the reafters to within a foot of the rood overhang. How do they expect the average homeowner to know what they are talking about. Even the builder doesnt know off the top of his head what was done since they dont have the records in their office anymore. Does this mean I have to tear off a section of my roof to find this crap out? I guess they figure people wont bother and just pay the higher premimum instead.

 

[smoseley]

xxx,

Sorry for everything you went through. My problems with UHC have obviously been less extreme. I'm still gonna fight them, though.

PS -

A tornado wiped out a bunch of houses across the street from me last year, so what are the odds of it happening again?

LOL... the same they were before it happened

 

[cantwaitforelise]

I'm not sure what the IDC-9 code for a cat bite is, but this may have flagged the insurance company as an accident rather than pre-existing. They may think that someone else may be responsible for the charges rather than them. Often times they will send you something that you have to sign that says it was not an accident. They often do this on fractures, sprains, ect. You may want to check into that.

 

[smoseley]

That wasn't it. They covered my previous doctor's visit and a later ER visit for the same thing. The thing they're disputing is the physical exam and the lab work for the cholesterol tests et. al. - even though I have no history of high cholesterol or anything. It's really absurd. The doctor's report says that I have "chronic tonsilitis" - that is a condition that could be considered pre-existing... except I've never received treatment for it!!! My tonsils are chronically inflamed... whoop dee doo... they've been like that for 16 years. Because a doctor writes that in his report doesn't mean you can make me pay for a cholesterol test and other unrelated crap! It's just a load of BS and people shouldn't have to deal with it.

 

[xxxotic]

That's wierd. I have my cholestrol checked every 6 to 8 weeks with UHC and just have to pay the doctors a $15 co-pay.
I think the actual lab charge is about $100-$120 for the test from what i can remember, or maybe that is the amount the insurance comapny sends to the lab. UHC has a couple differant plans too. One is for if you get to pick your doctor and another is if you go to a participating doctor.


LOL... the same they were before it happened

There is a trailer park about 1/2 mile away from me (actually its about 20 houses down from me and and across the highway) Thats where the tornado hit. I was hoping that they would just build houses there instead, since the trailer park is kind of old and outdated, but since it is affordable housing, they couldnt do it and let the people get new trailers. Kind of dumb since they will just get trashed again. Everyone on my street was fine, but then our houses were built after Hurricane Andrew hit and are built to hurricane code standards. I even have three steel beams for reinforcement on my garage doors. I guess the Lotus will be safe in the event of a hurricane!

 

[babak]

I'm not sure what the IDC-9 code for a cat bite is, but this may have flagged the insurance company as an accident rather than pre-existing.

ICD9 codes can be very specific or general, I can almost garantee that it was not coded specifically as such, it's a rare injury and would tak some digging around and most people would just use a NOS (not otherwise specified) to just get the paperwork filed. FYI:

E906.0 Dog bite
E906.1 Rat bite
E906.2 Bite of nonvenomous snakes and lizards
E906.3 Bite of other animal except arthropod
Cats
Moray eel
Rodents, except rats
Shark