Can she help?
After being told on 5 occasions by UHC that I would be covered for this procedure my surgeon's office turned in the claim and it was denied with a written exclusion from my employer. I have contacted benifits and they are talking to UHC about why they told me it was covered. This is the information I got from the person this morning. Do you think this means I may have a chance that they will overturn my case or do you think that she is just trying to teach UHC a lesson for telling me the wrong information?
Thanks!
The Benifits Representative forwarded your e-mail regarding the misinformation you received from UHC to me. I have asked UHC to investigate why this happened and how, but I will also need to ask you for more information.
According to UHC's records, the first call from you regarding coverage was on 5/1/06. (They do admit that you were incorrectly told that the procedure is covered. ) Does this date agree with your own records?
Also, they are only showing one claim since May 1, 2006. Do you have copies of other EOB's for services you received after they first told you the service would be covered?
Please know that our account management at UHC has been made aware in no uncertain terms that this kind of customer service is unacceptable. They have detected an error in their system, but I realize that it does not help you at this point.
Any additional information you can provide in terms of dates, names, costs, etc would be most helpful to us in pursuing this with UHC.