Health plans have been required by law to process claims within 30 days for some time now. United Behavioral Health has come up with a creative work-around for getting out of this requirement. It goes like this:
1. Steer consumers toward making their claims on an online claims submission screen that doesn't give the consumer a printable record at the end of the session.
2. Tell the consumer that the claims they just submitted won't be visible on the site for several days
3. When the consumer comes back to check the progress of the claim, show them a screen that says "no claims filed during the period requested"
4. Make sure the only customer service offered after regular daytime work hours is NOT empowered to investigate the missing claims; extra bonus points for using offshore "customer service" that gives customers wrong phone numbers to other "customer service" units
5. When customer finally finds time during their workday to reach a real customer service rep, have the rep pretend to be surprised at the situation. Ask the consumer if they are SURE they filed the claims. (These are behavioral health patients, after all... Could have been a hallucination or something, right?)
6. When consumer insists, be real nice and suggest they file the claims again. Doing it online is easy!
7. Lose the claims filed by the customer the second time
8. Repeat... Month after month, year after year. Most behavioral health claimants are already pretty stressed - they'll give up soon. They aren't really likely to complain about it to their employer who pays for the plan, right?
This is exactly what has happened to me, for several years. Just happened again tonight. (Paper claims didn't work any better in the past). They are set up to wear consumers down. It ought to be illegal... Wait, it IS illegal. It is really just too consistent to be a fluke. Who is a person supposed to complain to to make them stop this?
Luckily there are sites like this. One social networking site down... Dozens more to go...
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