EECB Scores Direct Hit On United Heathcare, Corrects $700 Billing Error

Nick was tired of getting the run around from his insurance company, part of United Heathcare, over frequent (and pricey) billing errors.

He didn’t think it would work, but he launched an EECB (Executive Email Carpet Bomb) anyway…

Nick says:

For the last 8 months I’ve been submitting claims online to United Behavioral Health (one tentacle of the evil squid that is United HealthCare), for out-of-network service that I’m supposed to get partially reimbursed for. When they don’t go through, I have to call customer service, talk to one of their incompetent reps, be patient while they act like I’m the one who did something wrong, and then wait even longer for my eventual payment. There’s absolutely no reason for this — nothing complicated about the claims, they’re the exact same kind that have been reimbursed before — except, of course, that no insurance company ever wants to pay anyone anything ever. I don’t think I need to elaborate any more than that, since it’s the same crap that everyone with insurance goes through.

Anyway, last week I got another one of these EOBs that claimed I was owed exactly zero percent of the several hundred dollars I’d spent. This was even more frustrating than usual because I’d had an expensive month and could really use the money. So, rather than spending time at work on the phone with another prickly-yet-stupid CSR, I decided to check Consumerist to see if there was any executive contact info for United HealthCare.

And there it was!

I fired off a non-threatening but firm email to the CFO, COO, and Senior VP/Treasurer in which I told them what was happening and that from now on, I would be corresponding directly with the three of them about any such issues rather than waste time with their phone support. While it was a satisfying note to write, I didn’t really expect anything to come of it. After all, these are some of the most senior people in charge of screwing customers, so they have more incentive than anyone to ignore me.

But lo and behold, I checked my claim status online the very next day (in fact, the same day they would have received the email, since I sent it on a Sunday night) and my reimbursement status for my most recent claim had already been modified. I figured the check would still take a while, but hey, at least I didn’t have to get on the phone. Wrong again! I got my checks in the mail yesterday, only a week after sending the email.

And yes, you read that right — CHECKS. A total of three. Not only did they reimburse me the proper amount for my most recent claim; they even sent me EXTRA MONEY from previous claims that they realized they’d screwed me on. Rather than get a couple hundred dollars in exchange for hours of bureaucratic frustration, I got almost $700 for a single email that took me three minutes to write. Frankly, I’m still in shock. If the EECB can get United HealthCare to voluntarily cough up money I didn’t even ask for, then its powers truly are limitless.

Thanks for posting that contact information, and for all the other valuable services that Consumerist provides.

–Nick

Good work, Nick! Sometimes all your problem needs is a little TLC from someone higher on the food chain. For more information about launching your own EECB, click here.

Comments

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  1. Crymson_77 says:

    Now, hopefully, they wont require him to send the checks back because they overpaid him….freakin’ health insurance companies!

  2. teh says:

    Yay! I love consumerist success stories; they almost makes me less of a cynic.

  3. hills says:

    I also had similar luck with Anthem BCBS – There was one manager of claims that actually knew how to get things done, so I stayed on her good side and whenever I had a problem I contacted her and it was solved very quickly.

  4. dmuth says:

    Was having similar issues with my health insurance company once. My doctor advised me to keep calling them and said, “There are exactly 11 competent employees at your health insurance company. And they are all very good at concealing their identities.”

  5. Really depends on the company to which you fire off an EECB. If it’s a company that’s known for screwing over people (like Delta, in my case) then it’ll be harder to achieve success with an EECB alone. I combined my EECB with a report to the attorney general’s office in addition to the BBB. It was only after notifying the BBB that Delta was “so sorry” for cheating me out of FF miles.

  6. shorty63136 says:

    Good job, Nick!

    Now lend me $50. :)

  7. aleck says:

    Now, imagine that you are a health care provider and have to deal with it every stinking day. And not just a single check, but your entire living depends on how well the claims are processed. I am not a doctor, but I knew one who said if he was diagnosed with a terminal illness, he would suicide bomb United HealthCare headquarters.

  8. campredeye says:

    I thought this title stated a $700 billion dollar error, I was itching to cash in.

  9. macinjosh says:

    I told them what was happening and that from now on, I would be corresponding directly with the three of them about any such issues rather than waste time with their phone support.

    This is my favorite part (emphasis added). :)

  10. bohemian says:

    There needs to be a legally binding penalty for purposely delaying a claim. Feined incompetence included.

    If insurance companies took a financial penalty every time they delayed a claim by one of the many ways they do so it would either pain them into holding up their end of the deal or compensate the consumer for the hassle. Maybe a $50 penalty per late paying claim or denial without merit. $25 for the health care provider and $25 for the patient.

    I played this game for 9 months with our old health insurance before they figured it out that I would ride their asses about every claim they tried this with.

  11. am84 says:

    Good for you! This makes me so happy. God, I hate UHC.

  12. nick_r says:

    @macinjosh: As the author of the email in question, I think the part you quoted was definitely the straw that broke the camel’s back. Those guys can brush off a lot of shit, but when someone threatens to start cutting into their precious Facebooking time, better start playing ball.

  13. EyeHeartPie says:

    I think the biggest problem with health companies like this is that they are solely responsible for determining if reimbursement is warranted based on how the execs/CSRs/adjusters are feeling at the time. The rules should be clearly stated, and a third (disinterested) party should determine if the stated rules warrant a reimbursement, on a case by case basis. This would take away the whole element of the insurance companies acting like “Do we feel like paying this money this week? Nah. We had a tough quarter. No reimbursement for this in-network visit to an approved doctor.”

  14. JN2 says:

    Sounds like what happened to me with the same company. I was sending forms to UHC and they were being sent back to me with no explanation. I finally got someone on the phone to tell me there was a different department to send counseling claims to but guess what? Too much time has lapsed for us to consider paying what we owe you. Have a nice day.

    Choose another healthcare provider you say? Hell, I don’t get to choose what my employer picks as the low-ball health provider.

  15. Carabell says:

    @EyeHeartPie: They do have those. I work at one

  16. facted says:

    @bohemian: This is very true. Insurance companies are notorious for denying a claim you deserve only to cave in months aftewards (when they’ve already made some interest/investment income on the money they’ve been holding from you). This happened to my fiance many times, but luckily she has the time and patience (not to mention the stamina) to hound them until they paid up. Imagine an 85 year old, in feeble health, who just got of out the hospital for whatever and has no one to help them at home…

    We do not tolerate errors from our banks in cashing checks, for instance, why should we tolerate errors from our insurance companies that can cost us just as much, if not more? Oh…because insurance companies have some of the largest, most powerful lobbies and it’s election season…

  17. Tiber says:

    @bohemian: Not bad, but once they’ve already been hit with the fee, they have no further incentive. The fee should be based on the length of delay. And it increases exponentially.

  18. margit says:

    UHC screwed me over two years ago, refusing to reimburse me a couple hundred dollars for prescription medication that was covered by the plan. Do you think it’s too late to try to get them to pay up? I could really use the cash and I was too ill to fight it at the time.

  19. dohtem says:

    @margit: I say go for it. If you have all your documents saved, why not? You have nothing to lose. Also forward it to your state’s A.G. office.

  20. bohemian says:

    @Tiber: Construction contracts frequently have late penalties involved. The same concept could work for penalizing insurance companies for dragging their feet. Make it a per week fine. Every week they delay they rack up another fine.

    I don’t think people fully realize exactly how rigged the insurance industry is these days. They have managed to lobby enough over the last 20 years to get to write laws themselves basically. It is disgusting and right up there with oil companies and big pharma in corruption.

  21. Forkboy3 says:

    Medical claims are a nightmare. Everyone (not just the insurance companies) is out to cheat the patient. They are hoping you’ll just get a bill and pay it. But once you take the time to understand the system, you’ll start noticing errors all over the place. Errors that pretty much always cost the patient more money.

    My favorite is the in-network doctor that tries to bill the patient the difference between the original billed amount and the amount that they negotiated with the insurance company. By the way, those original billed amounts are completely bogus. We once got a bill for $30,000 before the claim went through. The negotiated fee that the insurance company paid ended up being about $3,500. What’s up with that?

    The other way they get you is with the deductibles. It’s almost impossible to figure out how the deductibles are calcuated.

    Here’s a tip. If you ever get a bill that wasn’t covered by insurance, ask the provider if they’ll give you a discount if you agree to pay it right now. I’ve found that often they will knock 10-20% off the bill just by asking.

    Matt

  22. Angryrider says:

    Bravo! An EECB took care of YOUR problem. But not the suffering of millions of Americans, who don’t have health care because the companies say it’s not profitable.