Helpful # for United HealthCare

[catwoman]

Those who get supplies through QAS and are denied in-network payment by United HealthCare -- here's a number to try at UHC:
(800) 638-7388.
It's the "care coordination" line. If UHC is declining to pay QAS as being in network and wants you to handle it as a deductible, contact a rep at this number to get a case started on your behalf. Won't work with supplies already received, but will for future supplies.

 

[Karlynn]

Thank you Marsha. I think I'll be needing that number shortly. I need to replenish my supplies and it's a new year.

 

[catwoman]

Karlynn:

Call NOW to set it up, rather than when you need supplies. Paperwork has to go through a committee to get QAS approved as being "in network" since there's no one who IS in network to get supplies from.

 

[catwoman]

Good news!!!!!!

Good news!!!!!!

Karlynn:

Got a very quick report back from UHC this a.m. They've approved QAS as being an in-network provider, even though it's not. Insurance rep will get QAS to resubmit paperwork for claim UHC denied last week.
Coverage is at 90%.
I'll have to reapply beginning of 2005 for that year.

BTW, insurance employee told me there is NO ONE in network to get my supplies from.

Also told me that UHC will cover Lovenox shots as a bridge therapy when I have a colonoscopy done this summer.

 

[Karlynn]

The United Health Care saga continues. I called Care Coord. 2 weeks ago and was given a Network Gap Number. I called QAS with that number and reordered my supplies. The supplies are being delivered today.

Now the saga...
I received a call this morning from UHC saying "Oh, we DO have an in network provider and we are not approving your gap #"

I told them I wasn't told that the number was "pending approval"
"All our numbers are pending approval"
"Why wasn't I told this."
"You were read a statement at the end of your call."
"No I wasn't"
"Yes you were. All our agents read a statement."
"Well this agent did not, just gave me the number and said that should do it."
"Well, you need to refuse delivery of the supplies. Then call our in network provider."

Long, long story short. I got no where with them. I thanked them for calling me 2 weeks after the fact regarding supplies that kept me from having a stroke so they wouldn't be paying thousands of dollars for my stroke medical care.

I called QAS and asked about refusing supplies and explained my morning's drama. QAS was very kind and helpful. The agent went directly to his insurance department, then called me back and told me not to refuse the shipment. That sending it back to them was just like me throwing them out. To keep them and that they would pursue the issue with UHC and get it worked out.

I LOVE UHC. Customer Service kept telling me I needed to call Care Coordination to get it resolved. Care Coordination kept telling me I needed to call Customer Service to get it resolved.

 

[catwoman]

Karlynn:

Call Care Coordination back and ask why you were given a #. Ask if QAS has been approved as "in network" for you this year since there is no provider who is in network. Ask why customer service should be handling this. That makes absolutely no sense.

When I contacted Care Coordination @ UHC on 4/19/04, I was given a # at that time, did not write down what exactly it was for other than to locate the filework.
That was a Monday. By Wednesday, I had received a call from an RN saying that QAS had been approved as in network, even though it's not, because NO ONE is in network. That RN gave me her name & phone #, in case I have problems in the future. She said she was working with my patient care coordinator on this -- someone I had contacted in February concerning a colonoscopy for this summer. Caller on 4/21 also told me to use bridge therapy for the procedure.

 

[Karlynn]

Hi Marsha,

I asked them why they gave me a number if they still had to approve the network gap, why not wait to give the number after the approval. They said that is their policy, that all network gap numbers they give are "pending approval". This is clearly a case of the right hand not knowing what the left and is doing.

It's pretty funny that on April 21, they had no in-network provider. Apparently on April 28 (when I called), they didn't. Then someone sat around on my paper work for 2 weeks while they looked into getting a network provider.

QAS was so kind to say they'd take care of this. I'm sure they have a lot of UHC customers. The gentleman that helped me said that he'd never heard of this.

 

[catwoman]

Karlynn:

I spoke w/ someone at QAS yesterday and mentioned the problem you and I have had. I was told that QAS **was** in network last year, rep didn't know why they're not in network this year.

UHC should have approved QAS as in network by now for you. I think the approval is done individually, rather than ALL insured by UHC. But if they've approved one, they should approve others.

I have a Texas-sized 2X4 you can whack them with... That may get their attention!