Complaint / review text:
UMR/United Healthcare keeps denying all claims I have filed that I paid over $300/mo. For their insurance - and that was just my 25%. My company paid the other 75%.
I had a medically necessary hysterectomy in December 2008 due to ovarian cysts and polycystic ovarian syndrome. It was unavoidable because the cysts kept returning and I would otherwise have to undergo multiple surgeries to remove cysts as well as scar tissue from endometriosis.
UMR denied claims from both the anesthesiologist and the surgeon even though it was pre-approved and met all their requirements. I was supposed to pay $100 copay (which I did) and the rest covered at 100% since I used an in-network provider on a PPO.
This type of treatment and denial of coverage for no reason is wrong. This is the most serious and expensive denial they have done so far, but they have also denied more standard claims as well. It seems as if they have a policy of "deny and maybe the customer will just eventually pay it themselves to avoid bad credit".
Shame on UMR and United Healthcare!