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Re: UHC pre-authorization strategy

Posted by sleepy-in-seattle on July 31, 2007 at 18:02:50:

In Reply to: Re: UHC pre-authorization strategy posted by DarkStranger on July 31, 2007 at 15:06:20:

When I was hammering on UHC, they would routinely deny having received 30+ faxed pages I had faxed from my employer. My surgeon's office said they used to send them procedure proposals by registered mail, but UHC would deny that the person who had signed for the package was even an employee!

When they finally admitted receiving anything (this literally took almost five months) and issued a denial letter, I included in my appeal the threat to contact the WA state insurance commisioner's office. 28 days later (two days before the mandated deadline), UHC handed the case off to an outside contractor. The contractor called my surgeon's office to verify some facts. During the conversation he said (paraphrased) "I have no idea why this wasn't approved right away. It's clear that it is medically necessary and covered. I really don't understand why they're having me do this."

Though this may sound like an exception, I assure you this kind of stonewalling goes on every day of the week.

Insurance companies are businesses first and foremost. And like so many businesses, they have to be ruthless in cutting costs to remain profitable. The big problem is that some of their efforts have a human toll that is not readily apparent, and some of their policies encourage denial over compassion. Compassion is not a profit center!

Good luck on getting them to respond in the short time remaining.

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