I've been going round and round in circles with UHC and a new in-network provider over my ProTime 3 cuvettes.
When I asked UHC to once again certify QAS as being in network, I was informed that (1) there is an in-network provider now, I would pay $200 deductible and 10% after that; or (2) I could use QAS as an out-of-network provider, pay $500 deductible and 30% after that. I would still have to pay the $200 in-network deductible somewhere along the way during the year.
Unfortunately, dollars and cents won out over a track record of good service.
First phone call to the in-network provider told me the employees didn't have any knowledge about anticoagulation home-testing supplies. I was very discouraged and rightfully so.
I called UHC, told the care coordination rep about my experiences with the in-network provider.
She contacted the business.
Provider said my plan's contract w/ UHC did not include coverage of cuvettes, that they were disposable medical supplies and the contract did not specifically mention ProTime 3 cuvettes.
UHC said, yes, the contract did cover them.
Provider would not budge, would not use E1399 as code, as UHC requested, said it was illegal to do so.
Late last week, UHC threw in the towel on the in-network provider. I had a call Thursday from the provider saying that UHC had canceled my order, that UHC would order from the previous provider. I asked the CS rep if anticoagulation home-testing was a new liine for hem, and was told yes, but they really didn't carry the stuff, only if requested. (So that's why no one seemed to know what I was referring to each time I called!)
Friday morning I got a call from UHC's care coordination rep saying that UHC would certify QAS as being in-network for me for this year, and apologized profusely for the problems in dealing with the in-network provider.
There's a lot to be said for dealing with a company that knows the ins and outs of their products, ships merchandise promptly and cares about their customers.
All you have to do is be assertive.
When I asked UHC to once again certify QAS as being in network, I was informed that (1) there is an in-network provider now, I would pay $200 deductible and 10% after that; or (2) I could use QAS as an out-of-network provider, pay $500 deductible and 30% after that. I would still have to pay the $200 in-network deductible somewhere along the way during the year.
Unfortunately, dollars and cents won out over a track record of good service.
First phone call to the in-network provider told me the employees didn't have any knowledge about anticoagulation home-testing supplies. I was very discouraged and rightfully so.
I called UHC, told the care coordination rep about my experiences with the in-network provider.
She contacted the business.
Provider said my plan's contract w/ UHC did not include coverage of cuvettes, that they were disposable medical supplies and the contract did not specifically mention ProTime 3 cuvettes.
UHC said, yes, the contract did cover them.
Provider would not budge, would not use E1399 as code, as UHC requested, said it was illegal to do so.
Late last week, UHC threw in the towel on the in-network provider. I had a call Thursday from the provider saying that UHC had canceled my order, that UHC would order from the previous provider. I asked the CS rep if anticoagulation home-testing was a new liine for hem, and was told yes, but they really didn't carry the stuff, only if requested. (So that's why no one seemed to know what I was referring to each time I called!)
Friday morning I got a call from UHC's care coordination rep saying that UHC would certify QAS as being in-network for me for this year, and apologized profusely for the problems in dealing with the in-network provider.
There's a lot to be said for dealing with a company that knows the ins and outs of their products, ships merchandise promptly and cares about their customers.
All you have to do is be assertive.
