I wish I had read the reviews on OPTUM before we made an appointment with the OPTUM clinic located at 925 S. Euclid St in Anaheim. I just want to make people aware of this situation.
We have a high deductible health insurance coverage which does cover preventive services such as a basic blood test without having to meet the deductable. In September of 2023 we made an appointment with this OPTUM location for just a basic blood test and nothing else. They confirmed us that it would be covered 100% by our insurance.
When we came in the nurse took our blood pressure and she left. Then the doctor came in and asked us a few trivial questions such as what medications we are taking. I told her I have been taking amlodipine for high blood pressure and that was all. We had to wait a couple of hours to have the blood drawn. The nurse who drew our blood seemed like it was her first time doing the blood drawing for a blood test. We had to call OPTUM to get the test results after waiting a couple of weeks. They did not even bother to call us or mail us the results.
A few weeks later we received a bill from OPTUM for an office visit of $238.38 . We called to find out about the bill and were told to disregard the bill as the billing code was incorrect. Later we called OPTUM billing department to make sure the bill was voided. They said the bill was never voided and therefore we had to pay the full amount. We tried to negotiate the price down but they refused to negotiate. To protect our good credit we had no choice but to pay it.
So here is the lesson we learned from this incident. They say anything to get you to set up an appointment and come in. The doctor would use every trick in the book to turn it into an office visit such as asking you what medications you are taking. The doctor sends a prescription of the medication you are taking to the pharmacy even though you never asked for it. This is enough for the doctor to turn it into an office visit. OPTUM sends the bill to your insurance for the cost of an office visit. Of course the insurance won’t pay OPTUM because you have not met the deductible. Even if you did meet the deductible the insurance company will not pay OPTUM the full amount. OPTUM and other service providers always bill the insurance 3, 4 times the amount they expect to be paid. But if your insurance won’t pay them they hold you responsible for the whole inflated amount.
In conclusion this is a bad place to go to. Their practice is unethical and immoral. You should run far and run fast from OPTUM . But if you are in our situation and have no choice but to go to this place, here are my suggestions:
- When you come in make sure the nurse and the doctor understand you are not there for an office visit.
- Do not let the nurse take your blood pressure. This you can do yourself at home.
- Do not even step on the scale.
- Do not answer any questions the doctor asks you. Just tell the doctor you only want a basic blood test and nothing else.
I hope this will help the public avoid falling into the trap like we did.
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
Russell [redacted]
To whom it may concern, I am sending this email to let you know we were able to refund this member. We were not trying to not pay the member after review we found there was some turnover in our accounts payable department and had some training issues. We were however able to resolve...
Mr. [redacted] issue on 7/15/2015. We did contact Mr. [redacted] on that same day and apologized as well for the inconvenience. Sincerely, Pam J[redacted] | Optum Clinic + Urgent CareAssoc. Director of Clinical Operations
We have a high deductible health insurance coverage which does cover preventive services such as a basic blood test without having to meet the deductable. In September of 2023 we made an appointment with this OPTUM location for just a basic blood test and nothing else. They confirmed us that it would be covered 100% by our insurance.
When we came in the nurse took our blood pressure and she left. Then the doctor came in and asked us a few trivial questions such as what medications we are taking. I told her I have been taking amlodipine for high blood pressure and that was all. We had to wait a couple of hours to have the blood drawn. The nurse who drew our blood seemed like it was her first time doing the blood drawing for a blood test. We had to call OPTUM to get the test results after waiting a couple of weeks. They did not even bother to call us or mail us the results.
A few weeks later we received a bill from OPTUM for an office visit of $238.38 . We called to find out about the bill and were told to disregard the bill as the billing code was incorrect. Later we called OPTUM billing department to make sure the bill was voided. They said the bill was never voided and therefore we had to pay the full amount. We tried to negotiate the price down but they refused to negotiate. To protect our good credit we had no choice but to pay it.
So here is the lesson we learned from this incident. They say anything to get you to set up an appointment and come in. The doctor would use every trick in the book to turn it into an office visit such as asking you what medications you are taking. The doctor sends a prescription of the medication you are taking to the pharmacy even though you never asked for it. This is enough for the doctor to turn it into an office visit. OPTUM sends the bill to your insurance for the cost of an office visit. Of course the insurance won’t pay OPTUM because you have not met the deductible. Even if you did meet the deductible the insurance company will not pay OPTUM the full amount. OPTUM and other service providers always bill the insurance 3, 4 times the amount they expect to be paid. But if your insurance won’t pay them they hold you responsible for the whole inflated amount.
In conclusion this is a bad place to go to. Their practice is unethical and immoral. You should run far and run fast from OPTUM . But if you are in our situation and have no choice but to go to this place, here are my suggestions:
- When you come in make sure the nurse and the doctor understand you are not there for an office visit.
- Do not let the nurse take your blood pressure. This you can do yourself at home.
- Do not even step on the scale.
- Do not answer any questions the doctor asks you. Just tell the doctor you only want a basic blood test and nothing else.
I hope this will help the public avoid falling into the trap like we did.
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
Russell [redacted]
To whom it may concern, I am sending this email to let you know we were able to refund this member. We were not trying to not pay the member after review we found there was some turnover in our accounts payable department and had some training issues. We were however able to resolve...
Mr. [redacted] issue on 7/15/2015. We did contact Mr. [redacted] on that same day and apologized as well for the inconvenience. Sincerely, Pam J[redacted] | Optum Clinic + Urgent CareAssoc. Director of Clinical Operations