Unicare / Trying to deny preventive care claim!
1
Review updated:
Unwilling to honor their contract of providing a 100% covered preventive procedure. I researched and successfully countered each of their varying reasons for denial. They were either unable or unwilling to give the real reason. A message left for a supervisor was never returned. After hours on the phone with multiple agents over 3 days,and my refusal to hang up, they finally let me talk to a supervisor who said it was a specific medical coding error by the doctor. We'll see if they honor their contract with the corrected claim.
Date
I've talked to 7 UniCare reps about paying a 2-month old, pre-approved diagnostic test. They have stonewalled payment again and again citing everything from mis-recorded, mis-entered billing records, to "Um, I don't know why it hasn't been paid." Oh, and the reps have NO way to contact billing, nor do they provide any to consumers. Avoid UniCare at all costs!
I currently am having large amounts of claims denied under a "pre-existing condition" code yet NO ONE we talk to at Unicare can tell me what the pre-existing condition is. The fact is, there is none. I fractured a rib. They are denying doctor visits and x-rays under this code. If one day you have a whole rib and the next day it is in two pieces, how is there a pre-existing condition. This is just one incident of many in the past four months. The single worst decision we made was going with Unicare.
DON'T EVER CHOOSE UNICARE! One of the worst decisions we have ever made. They fight everything. The keep you on phone for hours, they do not hold to their promise. I could go on and on. As soon as we can switch we will.
I agree.. Don't go with Unicare. Same issues. Lab work covered at 100% - year later and still can't get the claim paid. They've given multiple excuess' on why they haven't paid. Now they're all into this pre existing issue. They want to know when I had the condition. Hello, Haven't had condition. Was testing for the condtion. Nothing wrong with ICD9 provided. Not too mention some common sense - If I had one I'd be getting medication for it.
Already sending information to Insurnace Commisioner
and Bureau of Consumer Affairs. I suggested everyone do they same.
I've had similar experiences myself. After confirming coverage for upcoming dr. appts. and procedures with a representative they denied two of our claims citing that it was billed incorrectly. This year especially they are denying claims more often causing customers to use valuble time to correct billing errors. I think it is appalling that sick people have to spend their personal time correcting rejected claims that unicare does not want to pay due to their financial deficits. I will personally be looking for another medical insurer next year when open enrollment comes around. I'm sick of arguing with this company over rejected claims that were eventually paid because they were rejected in error. They get 13, 000 dollars per year for our family plan and I still have to fight with them to pay covered procedures. Dissatisfied in Massachusetts