UnitedHealth Group

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. Issue has been resolved satisfactorily.

Initial Business Response /* (1000, 5, 2015/09/29) */
We are responding to your recent correspondence dated September 28, 2015, regarding[redacted].
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you regarding these...

concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description of the issue, we will be responding directly to the enrollee.
Initial Consumer Rebuttal /* (3000, 7, 2015/10/02) */
(The consumer indicated he/she DID NOT accept the response from the business.)
United Health Care never contacted me regarding this issue. This is a recurring issue and it happened again. I request United Health Care to call me immediate regarding the permanent resolution.
Final Business Response /* (1000, 10, 2015/10/05) */
A letter from United Healthcare Appeals Committee was sent to[redacted] regarding and addressing his concerns on September 29, 2015.

October 20, 2016     To Whom It May Concern:   We are responding to your recent correspondence dated October 19, 2016, regarding [redacted].   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond...

directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.    Should you have any questions or comments, please feel free to email us at [email protected].   Sincerely,   Katie [redacted] Consumer Advocate

June 6, 2016     To Whom It May Concern:   We are responding to your recent correspondence dated June 6, 2016, regarding [redacted].   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to...

you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.    Should you have any questions or comments, please feel free to email us at [email protected].   Sincerely,   Katie [redacted] Consumer Advocate

Initial Business Response /* (1000, 8, 2015/06/29) */
I am responding to your recent correspondence regarding Kathleen [redacted]. Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Revdex.com regarding these concerns. Since your...

letter provided a copy of the enrollee's correspondence and/or a description of the complaint, we will be responding directly to the enrollee once the matter is completely resolved. I want to assure you that this matter is currently being investigated by the claims team within UnitedHealthcare.
Sincerely,
Rhiannon F.
Initial Consumer Rebuttal /* (3000, 10, 2015/07/03) */
(The consumer indicated he/she DID NOT accept the response from the business.)
No one has bothered to contact me on behalf of United Healthcare, as is the crux of the problem. It is ridiculois that each and every month for years on end my healthcare premiums are paid but I can't get a covered expense paid, nor can I get anyone to answer my questions.

Initial Business Response /* (1000, 10, 2015/10/05) */
I am responding to your recent correspondence dated October 4, 2015, regarding [redacted]
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these...

concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description of the complaint, we will be responding directly to the enrollee.
Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at 800-343-4227 extension XXXXXXX.
Initial Consumer Rebuttal /* (3000, 12, 2015/10/06) */
(The consumer indicated he/she DID NOT accept the response from the business.)
They called to ask if I wanted a visit and did not mention the gift card. Therefore I do not accept their response.

December 1, 2016     To Whom It May Concern:   We are responding to your recent correspondence dated November 30, 2016, regarding Ms. [redacted].   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly...

to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.    Should you have any questions or comments, please feel free to email us at [email protected].   Sincerely,   Mark L. Consumer Advocate

I am rejecting this response because:
I don't see a letter from the business or a response. They called me from a number that I could not return a call from the number. a guy called me and left a number and 7 digit extension.  The extension was wrong. some lady answered the phone and ask me all kinds of questions that I could not answer because I was driving. I had to wait until I got off from work because no one know that I am sick. She transfered me back to the main number. I spend 3 hours on the phone trying to fix this issue. The drug and United health care should communicate. I am not a insurance drug guru. Are they trying to make me have a heart attack. My issue is not fixed.  I need my medicine.

Initial Business Response /* (1000, 5, 2015/10/20) */
October 20, 2015
Revdex.com of Minnesota and North Dakota
Attention: Taylor Keate, Mediation Coordinator
220 S. River Ridge Cir
Burnsville, MN 55337
RE: [redacted]
Dear Ms. Keate:
I am responding to your recent...

correspondence dated 10/19/2015, regarding [redacted].
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description of the complaint, we will be responding directly to the enrollee.
Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at 952-936-1982.
Sincerely,
[redacted] Seifert
Consumer Affairs Advocate
Final Business Response /* (1000, 7, 2015/10/29) */
Per Faxed Information from the business: "Thank you for you letter dated October 19, 2015, oh behalf of Mr. [redacted].
Due to privacy concerns, we are unable to provide more detailed information to you without a signed Authorization to Disclose Information from Mr. [redacted]. However, We have responded directly to Mr. [redacted] addressing his concerns.
Should you require additional information please feel free to contact me by phone at (XXX) XXX-XXXX ext XXXXX or at [redacted]@unitedhealthone.com.
Sincerely,
Robbin [redacted]
Senior Appeals Representative

To Whom It May Concern:   We are in receipt of your inquiry dated; April 5, 2017 regarding your request for assistance from [redacted] has been identified as a member of our Medicare Advantage Prescription Drug Plan (MAPD).  This plan is regulated by the Centers for Medicare &...

Medicaid Services (CMS).  Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you regarding [redacted]’s concerns.    Since your letter included a copy of the enrollee’s correspondence and/or a description of the complaint, we will be responding directly to the enrollee regarding their concerns.    United Healthcare has established an appeal and grievance resolution process in accordance with CMS regulations.  It is our position, and that of CMS, this process provides Medicare members with adequate recourse regarding any issues they may experience with their coverage, or any other services they received in connection with benefits provided by us.  We want to assure you this matter will be investigated and resolved within the CMS timeframes.  We have forwarded this complaint to our Appeal & Grievances Department so they can provide a written response to the complainant.  If you wish to find out additional information regarding how this complaint is resolved, you will need to contact Mr. [redacted] directly. Please note that grievances take up to 30 calendar days and appeals can take up to 60 calendar days.

Initial Business Response /* (1000, 10, 2016/02/04) */
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description...

of the issue, we will be responding directly to the enrollee.
Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at 800-842-2656.
Sincerely,
Linda **
Consumer Affairs Advocate
Initial Consumer Rebuttal /* (2000, 12, 2016/02/12) */
The consumer indicated that he/she ACCEPTED the business response.

Initial Business Response /* (1000, 5, 2016/01/19) */
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable
to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee's
correspondence and/or a description...

of the issue, we will be responding directly to the enrollee.
Should you have any questions or comments, please feel free to call me. I can be reached during normal
business hours at [redacted] ext [redacted].
Sincerely,
Tanya
Consumer Affairs Advocate
NOTICE:
Initial Consumer Rebuttal /* (3000, 7, 2016/01/21) */
(The consumer indicated he/she DID NOT accept the response from the business.)
This response is unacceptable. Since I filed my claim, the following has occurred: I received a message from someone in the office of the last rep I spoke with, indicating that if I had any questions, I should call the # on the back of my insurance card. Which means beginning a new dialogue with someone unfamiliar with this issue. While a file # was given to me to share with any rep, it's not the same as follow up with someone that I spent an hour on the phone with. When I called the # listed in the response, I was not given the chance to enter an extension; the only option was to leave a message. I had no idea who I would be leaving a message for so I did not. I then called the # on my card and got a rep on the phone. He looked up the file # I was given in a message from the last rep I spoke with prior to my complaint. He mentioned the file was lengthy and shared some information with me. That information referred to the second claim, which was actually processed correctly. It was the first claim (March 2015) that is still not resolved properly. I am appalled at how I cannot speak with the last rep, who specifically gave me her direct number in case I had further questions. It's also deplorable that I had a message to call the number on my card. Which means spending yet another conversation recalling the entire issue, with yet another, different rep. UHC is acting in a most unprofessional manner, and is not following up with what I was told numerous times with regard to reprocessing the first claim as if it were in network/in contract. I just got off the phone with another rep (after calling the generic # on my card) and he couldn't help me. I asked to speak with a supervisor but they were busy and he assured me I'd get a call back in a day or two. I cannot express my frustration over this matter. I kept being told by UHC that the March claim was processed incorrectly; that multiplan shouldn't have been used, that it should've been processed using IN NETWORK or CONTRACTED rates which are very different from multiplan. I was told it numerous times I was correct, it would be redone and I would hear back from whomever I spoke with. Neither has happened!
Thank you for your assistance.
Final Business Response /* (1000, 23, 2016/02/17) */
February 11, 2016 I made direct contact with the member to address their concern

This message is to confirm receipt of Ms. [redacted]’s concerns. Thank you for bringing this matter to our attention.   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to the Revdex.com regarding these concerns. However, we will...

research and respond directly to Ms. [redacted] with the results of our investigation.    Should you have any questions or comments, please feel free to email us at [email protected].

Thank you for bringing this concern to our attention. Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to the Revdex.com.  However, we will be responding directly to [redacted] to address their concerns.

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the...

enrollee.  Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ###-###-####.     Sincerely,   Jenna [redacted] Consumer Affairs Advocate

UnitedHealthcare will be working directly with the member to resolve this issue.

I am rejecting this response because:I had this problem as of last year 2016. I was put on Medicare part B by the state of Florida.  Because of this I had money taken out of my SSD  which I been fighting to have this stopped. Before this United health care had a gentleman singing people up for health care. he had stated to me that I can get my medication free at no charge and more. I thought it was a good Idea. when time went by I was about to lose my va benefits. I have called united health care about this plan I was put in was totally miss leading. I was having problem with my VA because of this I like to drop the plan which was at no charge. I have received a letter from United Health Care Dated February27 2017  about this and stated there is a copy of a form that I have signed. There was no form with my signature on it. I have called 3 times  the number on the letter is ###-###-#### no answer, an help I have left message for Michael Baker which has signed the letter I have I like to have United health Care cancel this an clear me of any money owned to them. One they did not show any proof of a form I have signed which I did not sign, or give any one permission to put me on any plan. If I have to I will file a police report of Identity theft, then file a complaint with consumer affairs if United health care does not take care of this problem. You call me at ###-###-#### or email me at [redacted]@gmail.comThank You[redacted]

Thank you for bringing this concern to our attention. Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to the Revdex.com.  However, we will be responding directly to [redacted] to address their...

concerns.

September 30, 2016   Revdex.com Attn: [redacted] 220 South River Ridge Circle Burnsville, MN 55337   RE:   [redacted]:   Dear Ms. [redacted]:   I am responding to your recent correspondence dated September 26, 2016, regarding [redacted].   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns.  Since your letter provided a copy of the enrollee’s correspondence and/or a description of the complaint, we have respond directly to this member regarding this issue. He reports the issue has been resolved.   Should you have any questions or comments, please feel free to call me.  I can be reached during normal business hours at ###-###-####.     Sincerely,  Jeff [redacted] Consumer Affairs Advocate

April 25, 2016 To Whom It May Concern: We are responding to your recent correspondence dated April 14, 2016, regarding Mr. [redacted]. Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you regarding these concerns....

Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.  Should you have any questions or comments, please feel free to email us at [email protected]. Sincerely, Mark L. Consumer Advocate [redacted]