UnitedHealth Unapproves Surgery From 2 Years Ago, Wants $7700 Back

United Health Care, not content with merely denying life saving cancer procedures or refusing to pay for basic (covered!) checkups, took things to a new level by retroactively un-approving procedures they paid for in 2005. They sent reader Suzanne a letter and a bill for $7700, claiming the pay-out was an “administrative error”, and she needed to pay up. Check out the details, inside.

Hi there – I’m really hoping you and your readers can help me with my problem. I had two procedures done in December 2005 (laprascopy and a hysteroscopy). Prior to the procedure I called United Healthcare (my provider) and asked them if the amount the doctor was charging was considered reasonable. I didn’t want to have these procedures done by this particular doctor if insurance would not cover the cost (I had another ready to perform the procedure who was in-network). After being reassured by United Healthcare that the cost would be covered I decided to go with the out of network provider. A few weeks later I received almost the full amount for the procedure – they covered about 90%.

This week I received a letter from United Healthcare telling me that they made an administrative error and that they wanted me to send them a check or money order for 7700 dollars! This is almost three years later!!

I’m shocked and plan to appeal. Can they do this? I mean, it is almost three years later!?!?

I know UnitedHealthcare is really horrible when it comes to claims/billing but this is insane.

Thanks for any help you can provide.

Suzanne

Yeah, of course United Healthcare sees paying for your procedure as an “error”. We sent Suzanne to our list o’executve email addresses for United Healthcare, and hopefully she’ll be able to convince United Healthcare that this is just ridiculous. They approved her claim years ago, and they’re just going to have to deal with it. Unless, of course, Suzanne forgot to call “no takebacks”.

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