* * * * * Insurance Question * * * * * * *

I am having terrible problems from United Healthcare getting approval for my son. They have been throwing up roadblocks every step of the way. One dept. says he is covered, claims says he is not. They are contraidicting themselves. I was wondering if they are doing this due to the fact that Dr. Champion is not in their network. Does any one out there have any experience with this? Perhaps if I go to a physician in their network it may be easier. Any info would be appreciated.

Are you asking if Dr. Champion is covered or if the surgery in general is covered? I have a few friends that have been denied because it was an exclusion. I would call your insurance directly and ask them if there is an exclusion for the surgery. If so request a certificate booklet with the exclusions. I hope that helps. Amy

Thanks for the reply. What happened was we were not told about an exclusion at all. We called uhc 12 times and every time they said there was no exclusion and he was covered. When the letter got to claims they said there was an exclusion. We contact customer service and they said claims was wrong he is covered. I spoke with two supervisors who assured me he was covered and they would get back with me. I called his human resource dept. - told them the problem. They contacted United and United told them he was covered. Then guess what - after four and a half months with United - Andrew and employees finally get an insurance books - and of course there was an exclusion printed. If I knew about this I would never have starting the process - but UHC kept assuring me he was covered for the surgery. Now UHC us apologizing and well as his employer also. UHC claims they made a mistake with Andrews file. They will let me know in 48 hours if they will pay for the surgery. They claim that since it was their error and my calls were recorded - they may possibly approve his surgery. I will know more later.