UPDATE: EECB Scores Direct Hit On United Health Care

Alexis writes:

Hello, Consumerist. I read your blog daily but hoped I would never have to write in. Unfortunately, that day has come. I am covered by United Healthcare under my employer. On April 23rd of 2007, I went to my OB-GYN for my annual checkup. I did not receive any additional tests, services, etc, just the basic yearly checkup. I paid my $10 co-pay, which is all that is required for routine annual checkups such as this, and I was out the door. About a month later, I received a bill from my OB-GYN stating that UHC did not cover the visit and that I owed them $90, because I had already paid $10 at my visit. UHC stated: “This Preventative Physical Examination Or Related Test Is Not Covered.” I called UHC and told them that all I had received was an annual check up. They apologized and said it was taken care of and that I did not owe any other money. Well, it is now February 21 2008, and I am still getting bills for $90 from OB-GYN Associates of Pittsburgh.

I have made an obscene amount of phone calls and wasted more time than I care to think about. After being told different various lies from UHC (i.e. “You weren’t covered at the time of the exam,” and “They are not in our network”), I finally thought I may have reached the bottom of this mystery. In early December, a supervisor at UHC told me that I needed to have the doctor’s office re-submit the claim under a different doctor with an individual in-network tax ID number, because they initially submitted it under the name of nurse practitioner who performed my exam, and she is not recognized nor covered under the UHC network. Easy enough – I called the doctor’s office and they complied. (Why did it take so long to get that answer? Why did they lie so many times in between?) The claim was processed on December 4th of 2007 under a doctor’s name who is covered and recognized under UHC, and an Explanation of Benefits was drafted showing I owe $0 from this visit. Finally, I thought this $90 had died.

I was wrong. Like a zombie, the $90 never dies. Just yesterday, February 20, 2008, I received yet another bill from OB-GYN associates of Pittsburgh asking for $90 in the mail. I thought I was going to hit the roof with anger. I called the doctor’s office this afternoon and asked what was going on. They told me that UHC refuses to pay them the additional $90 for the exam because, yet again, it “wasn’t covered.” I call UHC and get the same BS again regarding re-submitting the claim under an individual in-network doctor’s tax ID. When I told Jennifer, the representative, that they had already done this in December of 2007, her response was, “Well, obviously NOT.”

It’s obvious that UHC is just trying to save $90 by forcing me to get so frustrated that I just end up writing the doctor’s office a check. While $90 isn’t a lot to most people, (and really shouldn’t be a lot to UHC) it is to me, and it is also so incredibly unfair of UHC to be doing this, both to me and the doctor’s office. The bottom line is that they are NOT going to get that $90 from me, because I don’t owe them a cent more than my $10 copay.

This has been going on for almost a year. I’m at the end of my rope.

I ended up filing a formal complaint with UHC. If it is not resolved, I will take the issue to the PA Attorney General’s section on Healthcare. I would LOVE to do an EECB but I can find absolutely no e-mail addresses for any executives online anywhere. What is my next step?

By Googling searching *@uhc.com I found a find a number of uhc email addresses. (The asterix works as a wildcard when doing computer-based searches). UHC’s email address seems to format in three different ways, which I’ve ranked here from most prevalent to least:

firstname_firstinitialofmiddlename_lastname@uhc.com
firstname_lastname@uhc.com
firstletteroffirstnamelastname@uhc.com

I would suggest combining that with this list of executive officers…

Stephen J. Hemsley > President, Chief Executive Officer, Director
George L. Mikan III > Chief Financial Officer, Executive Vice President
David S. Wichmann > Executive Vice President; President of Commercial Markets Group
William A. Munsell > Executive Vice President, President – Enterprise Services Group
Thomas L. Strickland > Executive Vice President, Chief Legal Officer
Lori Komstadius Sweere > Executive Vice President – Human Capital
Anthony Welters > Executive Vice President , President – Public & Senior Markets Group
Eric S. Rangen > Senior Vice President, Chief Accounting Officer
Richard T. Burke > Non-Executive Chairman of the Board
Thomas H. Kean > Director

…And see if emailing your complaint to them gets you anywhere. Most of the addresses will bounce but perhaps a few will get through. If nothing happens, try a notch down the corporate ladder and find a list of regular VPs. You have a completely valid complaint, it just needs to be looked at by someone with half a brain to push your resolution through.