Reason One Million And One Why United Healthcare Sucks

united healthcare sucks

United Healthcare has long been my least favorite insurance company in terms of interacting with the staff. Ironically, I have never had significant issues with the coverage. It has all been related to the customer support. They are the worst insurance provider about playing the transfer game. Each time I get transferred I have to explain my situation over again to the new rep. Their automated systems takes forever. The system asks for a member ID, and the first thing the rep asks for is a member ID. They have outsourced much of their support to the Phillipines. My calls consistently get dropped. The return a call system makes you enter your phone number despite the fact the system already says it pulled your number out of caller ID. In short, I typically have to call United Healthcare about 10 times to resolve an issue, whereas other companies get it right the first time. I envision some manager on their side applauding the fact that average call times are under 3 minutes, willfully oblivious to the fact that customers have to call in over and over again to resolve the issue.

tdi complaint form

What Did They Do This Time?

I had to refill a prescription in early January after recently having transitioned to COBRA. The COBRA hadn’t been processed yet, so I had to pay for my prescription out of pocket. This is no big deal and standard practice. When my COBRA kicked in a called the company asking how to be reimbursed. The woman told me to Google Optum RX reimbursement form. You can see the form that comes up here. I thought it was weird, but it seemed plausible since Optum and United Healthcare seem to have the same parent company, despite the fact no one at either organization would admit that. After seeing some weird pharmacist boxes on the form, I decided that I better call again. This time I was told to go to Myuhc.com, click on find a form on the upper right, and Health Reimbursement Claim Form. You can see a copy of the form here. The first half page of this form advises the customer to go online for quicker service. This sounded great to me since I hate to deal with paper forms.

go online

One of the first things that stood out to me was how vaguely the instructions were written. “Follow steps to submit a claim form.” Have they never seen the maze that is their own website! Anyway, I followed the path that seemed most logical.

claims and accounts

submit a claim for reimbursement

mail the form

The website dead ends with an address, saying to mail the claim form. This is after the first half page of the form I was told to use by a rep on the phone said to use the website. I thought that I must have followed the wrong navigation route, so I called yet again. The customer service rep told me that they have no digital system to transmit claims. What really got me is that when I said I am staring out a form that says go online, she was utterly indifferent. She didn’t even act like she might look into the issue. I mean this claim form is hosted on the homepage of the United Healthcare website!

 

Here Is Where It Gets Better

As I am talking to the CSR, she asks if I need the address for where to mail the form. I said no an El Paso address is listed at the bottom.el paso address

The customer support rep then commences to tell me that is the wrong address for my group and if I were to mail it to El Paso there is a strong possibility my claim would never be processed. At this point, I said first the form that I was told to use by a United Healthcare rep tells me to use a mythical online claim submission form. Then the address listed on the form would be a black hole if I were to mail the form there. This is all after being told to use the wrong reimbursement form by the first customer support rep. I told the representative that I had 0 confidence that United Healthcare would process my form correctly. She said oh no sir it will be handled correctly, just make sure you mail it to the right address. I literally felt like I was in la la land. The whole process took 2.5 hours of my life that I will never get back. I can only hope and pray that the claim will be processed correctly.

Can these giant mutli-billion dollar companies not allocate a few jobs for people to go through the system as a customer would to audit the user experience? I was given the wrong information over and over again in a manner that would have resulted in my claim not being processed correctly. Whose fault would it be if they didn’t receive my claim in time? Ugh

Update – February 12th, 2015

United Health Care added insult to injury today. When I logged into my account, I saw that my claim was denied. The reason given was that the form was mailed to the wrong address. The CSR claimed that the form I provided (as directed by a separate CSR) wasn’t even the right form. I was infuriated. He tried to tell me that my only remedy was to mail the correct documents to a different address. I turned into “that guy.” I initially demanded to have my call escalated. He repeatedly told me there was nothing they could do. I finally asked to be transferred to an American. She claimed that she would have them forward the form to the correct department, and I should be reimbursed in 10 to 15 business days. I’m not holding my breath, but I was glad to talk to someone who said they could actually fix the issue. It absurd to have the front line CSR’s be so poorly trained that they consistently provide incorrect information on basic issues.

united healthcare claim denied

Update – February 28th, 2015

I just logged into MyUHC. My claim is still listed as denied for the same reason stated previously. It has been sixteen days since I was told the issue would be fixed. To add insult to injury, the automated system hung up on me after saying our office is open from 8am to 8pm local time. It is currently 6:52pm local time. I am so angry I can scream. How can such a large company be so incompetent. One of the suggestions my mother gave was to file a complaint with the Texas Department of Insurance. I am going to call again tomorrow and reference my cause number. If the problem isn’t fixed, I will certainly and gladly file a complaint. You should see if your state has a similar online form if you are experiencing the same type of hell.

tdi complaint form

 

Update 3-11-15

I called back again today and spoke to five different people. The first call dropped as is common with United Healthcare. The part that gets me about the dropped calls is they never call you back when that happens. I can literally sink an hour talking to one rep and if the call drops, I have to start all over again from the very beginning. The people in the Philippines were telling me I needed to talk to my plan administrator through my work. This made absolutely no sense. United Healthcare had paid all the previous bills. I asked to be transferred to an American again. The American told me I had to file the claim with Optum (which as we all know is owned by the same parent company as United Healthcare). The Optum person escalated me to a supervisor. The supervisor said she escalated me to some specialty person. That person is allegedly supposed to call me back in 24 hours. It sounds like at this point United is trying to get me to start the process all over again and submit the claims to Optum a company they own in the first place. Let’s see if they actually call me back.

Update 3-12-15

I waited well over 24 hours and had no call from Optum / United Healthcare. I called in and demanded an American again. The representative in the Philippines tried to make me explain my issue. I became irate and he transferred me. I got a very nice rep named Josh. He called over to the Optum side and got the 24 hour response again. He said one of two things will happen, they will either issue the reimbursement or make me start all over with the paperwork again. He vowed to call me back during his offline time.

Update 3-13-15

I still never received the mythical 24 hour call back from a supervisor, but Josh stuck to his word. He called me back today and said they are going to process my claim and put the money back on my credit card within seven days. Since I have heard similar claims in the past, I am still cautiously optimistic. I was incredibly impressed by this particular rep since no one else at United Healthcare, including supervisors seemed to care.

Update 3-17-15

My prescription claim has now disappeared entirely from MyUHC.com. I logged into my bank account and finally saw my reimbursement! They didn’t even keep my $40 co-pay. It was a complete refund. A refund I worked damn hard for.

optumrx

 

Note About Filing A Complaint Against United Healthcare

During all of my calls, no one seemed to care when I said I was going to file a complaint with the Texas Department of Insurance. My mother assured me that this route would suck for them, but she wasn’t sure how long someone should have to wait. The other important fact is that you need written documentation of the events. This is hard to provide when everything is verbally said during a phone conversation. A couple friends pointed out that if you have Google Voice, it is easy to record a call by pressing 6. United Healthcare has the standard disclaimer, saying calls are recorded. My friends asserted (none of us are lawyers) that if they have that disclaimer, you are allowed to record the call without notifying the rep. If this is completely true, this could be an effective way to provide your states insurance commission with proof. If you are going through an ordeal similar to mine, you might want to investigate.

 

The United Healthcare Mission Statement – What a Joke!

The United Healthcare mission statement is a classic example of the disconnect between people who make decisions and espouse grandiose values and how their never ending cost-cutting measures impact consumers. I cringe to think how much the company spent crafting these lies.

united healthcare mission statement

How to File Insurance Complaints in Other States

Remember to start documenting early. Keep meticulous notes, and save every bit of paper. Try using the Google Voice trick to record the phone call if they have a recorded call disclaimer. (This is not legal advise. Check your local laws first.)

Comments

  1. I have been double and triple charged every single month I have had insurance with United Health Care. I than have to call on my only free time for hours, and I mean hours to speak to a customer service rep that has no clue or understanding and I am usually redirected many times. I have this month again been charged over double my premium for no reason and cannot get through to anyone, the lines are so busy they refuse to speak to customers. The worst is while on hold listing to that annoying song over and over there is a voice saying how easy it is to get answers on line which is a complete lie. I just want to pay my “affordable” overpriced insurance premium and never have to talk to the worst customer service on the planet. I have never paid so much and gotten so little. This multi-billion dollar business is atrocious and if I can actually talk to someone in the next few days I am cancelling my policy and paying the bullshit tax to the IRS. United healthcare is so terrible, I would actually rather give my hard earned money to the IRS for no reason than to their company.

  2. From being a past UHC employee for over 10 years I can say without a doubt they do work very hard and if your get a CSR in the US they do want to help. Unfortunately, United has acquired so many organizations over the years they have become a quilt of many systems, processes, procedures, and politics. It’s one of the reasons why company consolidation is often a very bad idea. Companies are desperate to show double digit profits year over year to wow stockholders. Because of this expectation of Wall Street company’s outsource and don’t put the proper capital behind integrating their post merger world. Almost every major merger of another company became a disaster at some point because they refused to put their financial support to do it right the first time. As a result it was only when the “bomb” dropped and resulting “wildfire” was out of control do they actually (and half heatedly) try to fix the problem. I had heard that UHC acquired a Pharmacy Benefit Management company and all their specialty services are done managed by their “Optum” segment. (which people will know by different names because that this the other thing United loves to do is change their segment names just to make things confusing for anyone who is involved with the business. A perfect example is the employer group business was known by 4 different names during the 12 years I was with the organization. Medicare business likewise changed names at least 6 times. Guess they hoped the senior population wouldn’t realize it was the same company who screwed them over the prior year because the name changed.

  3. As a provider trying to work with them for several years, they are hands down the worst insurance company I’ve ever had to deal with. Other phone calls that take 5min with other insurance companies (e.g. Blue Cross, Cigna, Aetna) take 45min with them.

    Today I was on the phone with them 3 separate times. Each call took over 30min. The first two times I hit a brick wall when they said the patient hadn’t given permission for them to speak to me (which was fine the first time). The patient assured me that he had given them permission, but shrugged it off and he called back a second time.

    After getting notification from the patient that I was good to go, I called back a third time (supposedly using a number that would bypass their prompts, but all it did was take me to their main menu). Soooo, I supplied all the information again to both the computer prompt and the rep and then the rep told me that the current benefits weren’t showing and asked me to hold while she pulled them up. After 8min of complete silence I was concerned that maybe the call had a bad connection so I said “hello” a few times to which she nonchalantly responded “I’m still here.” She then told me that she was unable to give me the benefit information because it wasn’t showing. She said she could submit some sort of a ticket and that I could call back in three days. Uhhhh… no.

    If this was a unique situation I wouldn’t be writing this review. However, I’ve been hoping United would get their act together for a looooong time. Several years ago I opted out of being a provider for them. Occasionally, I still have to deal with them though since they cover the mental/behavioral health of some plans (even though people think they have BCBS insurance).

    From their telephone prompt (which doesn’t work half the time), to their staff (who are undertrained and under qualified), everything about the company is cheap and outdated.

  4. I used to work for UHC in the call center. Let me give you an idea what they are to do:
    Calls are to be determined in five minutes where it goes, to resolution, or elsewhere.

    Employees are timed and monitored, even the phones are tapped to make sure we do this. The employees are also “coached” as to what to say ” Do I have the pleasure of speaking with” and “Please take the survey..” at the end of each call. We don’t, we can be fired.

    Why something isn’t covered is up to your employer (and they have to pay) , but employees cannot tell the member this. Instead call center reps are yelled at by angry members and all along, we play along : ” oh I understand” and ” Yes, I can imagine how you must feel”.
    Those are judged as well. We HAVE to say we “care”. We don’t, not one iota.

    Customer Service reps who go outside the box and resolves a call to the customers delight are “coached” to follow the call center flow chart. They can be written up or fired if they do not.

    Resolution is usually a Resolution “expert” who by basically brown nosing the supervisor, gets the job. They don’t make any changes, but only they can pay a claim.

    Supervisors do nothing more than babysit numbers, matrices, time off, time on phones, whether we hang up the call or the member does. One female supervisor was hired and did nothing but her nails each day.

    The phone systems are Cisco and are incompatible with the Windows Unix platform used. The calls drop like crazy but rather than repair the system, they fire the employee.

    The “trust” thing is another in a series of slogans that UHC comes up with at an average cost of 300 thousand a slogan. I wouldn’t trust UHC to pay for a bandaid.

    While the employee health plan sucks at a 5 THOUSAND deductible and 80% coverage, the CEO lives in a nice 13 million dollar home on a MN lake. His insurance is free, too. Employees are screwed right and left, while UHC is transferring all call centers to the Philippines, where pay is 5.00 an hour instead of the $14-16 an hour here. THAT is why Customer Service sucks.

    Oh and the thing about Insurance Commissioners. UHC seems to think they are exempt from their regulations and will be happy to tell you so when you complain.

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