Ascension + United Healthcare = Clusterfuck

[CooterBrown 18287]

Back in July, my doctor submitted a claim to United Healthcare for $1,700. It was denied because they said I had other primary insurance. I did not have any other insurance. I called UHC and had that issue fixed on their end and waited for them to reprocess the claim as they said they would.  They didn't.  For 5 months, I have called UHC to reprocess the claim and now says they have no record of denying the claim (it no longer shows up in my online account) and Ascension says they cannot resubmit for reasons.  Well, Ascension finally submitted it to collections.  Ascension now says they really for real can't resubmit it because it has gone to collections.

Is there any way to resolve this clusterfuck? 

 

Edited Wednesday at 04:59 PM by CooterBrown

[bluto 4995]

it might involve a mustached plumber in green overalls. 

[Js1 87174]

We are willing to be your alibis 

[UT_OB1 2266]

1 hour ago, CooterBrown said:

 

Is there any way to resolve this clusterfuck? 

 

Can you 3d print a gun?  

[NoName 17146]

3 hours ago, CooterBrown said:

Back in July, my doctor submitted a claim to United Healthcare for $1,700. It was denied because they said I had other primary insurance. I did not have any other insurance. I called UHC and had that issue fixed on their end and waited for them to reprocess the claim as they said they would.  They didn't.  For 5 months, I have called UHC to reprocess the claim and now says they have no record of denying the claim (it no longer shows up in my online account) and Ascension says they cannot resubmit for reasons.  Well, Ascension finally submitted it to collections.  Ascension now says they really for real can't resubmit it because it has gone to collections.

Is there any way to resolve this clusterfuck? 

 

Do this, exactly:

Write it down in a letter. Include as many details and dates as you can. Be specific.

Send it via certified mail to Andy Davis, CEO at 1345 Philomena St, Austin TX 78723. He is the Texas CEO for Ascension.

Send another copy of the same letter to "Patient Relations Coordinator" at the address of the facility you had the services rendered. Also certified.

You can also CC the CEO of the individual facility where you had the services rendered.

You are filing a grievance, which kicks off a very specific process inside the house for those facilities.

If this is a physician office that may or may not help as much as if it's an inpatient / outpatient case. But this will get movement.

Edited Wednesday at 08:39 PM by NoName

[Nice Guy Eddie 13725]

What a mess. My guess is that while UHC made the original mistake, I would bet they were waiting on more information from Ascension who never sent it. And then UHC deleted the claim as neither approved/denied. 

[Nice Guy Eddie 13725]

5 hours ago, CooterBrown said:

Back in July, my doctor submitted a claim to United Healthcare for $1,700. It was denied because they said I had other primary insurance. I did not have any other insurance. I called UHC and had that issue fixed on their end and waited for them to reprocess the claim as they said they would.  They didn't.  For 5 months, I have called UHC to reprocess the claim and now says they have no record of denying the claim (it no longer shows up in my online account) and Ascension says they cannot resubmit for reasons.  Well, Ascension finally submitted it to collections.  Ascension now says they really for real can't resubmit it because it has gone to collections.

Is there any way to resolve this clusterfuck? 

 

dumb question but is it possible for you to submit the claim to UHC based on the documentation that you have from Ascension? I'm sure UHC doesn't want you to do this but that doesn't mean you can't.

[destroya 403]

Is it employer insurance? Your insurance agent may be able to help out. You may also want to call your state rep or state senator. They can reach out to UHC government relations, Ascension and the Texas Department of Insurance. 

[CooterBrown 18287]

23 hours ago, Nice Guy Eddie said:

dumb question but is it possible for you to submit the claim to UHC based on the documentation that you have from Ascension? I'm sure UHC doesn't want you to do this but that doesn't mean you can't.

I hadn't thought of that.  Looks like UHC allows you to submit the claims yourself.  Now I am just waiting on my doctor to provide the health summary report which has all the diagnosis and service codes I need to enter on the claim.