United Health Care / appeal process set up as impossible to file
California Ins. Commission
To Whom It May Concern,
This is in response to United Health Care’s, Dec. 20, 2014 letter which I received Jan. 2, 2015.
I would like to file a complaint, for they have made it impossible to file into their appeals process:
1. The necessity for numerous MRI’s is because of doctor, surgeon’s error. 3 MRI’s to date. 4/2014, 11/27/13 and 11.24/14. Why should I have to pay because of the surgeon’s error?
2. I was not even notified of the co-pay until I was billed, 6-9 months after the MRI services where rendered. U.H.C. states you have to appeal within 60 days but if you do not know of the co pay till 6-9 months later, how are you to appeal?
3. I, only, recently, 12/2014, was notified by United Health Care that you have to appeal the services within 60 days of your medical provider, acknowledging the services, but U.H.C., also, notified me that I would have no acknowledgement of when that medical provider is acknowledging the services, so I would have NO WAY OF KNOWING WHEN THE MEDICAL PROVIDER ACKNOWLEDGES THE SERVICES. I have 60 days after medical provider acknowledges to U.H.C. of services but I am not notified when that is, so I can file an appeal, making the appeals process an impossible feat.
4. Since, I would have no way of knowing when the medical provider acknowledges the services, there is no way for me to know when the 60 days to appeal starts. Again, I am not even notified of a co pay until billed, by the medical provider 6-9 months after the services are rendered.
5. Example: I now had my 3rd MRI, 11/24/14. I immediately, after 11-24-14, MRI, appealed the co-pay (now that I know of the co pay) but United Health Care 12/2014 (see letter dated Dec. 20, 2014 & received Jan. 2, 2015) notified me that I cannot appeal the co pay until the medical provider acknowledges the services rendered but I will not know when that is. If I am not notified when the 60 day appeal time starts, then how can I appropriately appeal it within 60 days? In fact, I’m not notified until 6-9 months after the services rendered and only though billing.. The Appeals process is an impossible feat.
6. I have, already, appealed the 3rd MRI, 11-24-14, co pay but United Health Care refuses to accept my appeal. I am a Senior, I feel this is some sort of crazy making abuse upon the part of United Health Care.
AB 2347, authored by Assembly Member Lorena Gonzalez (D-San Diego) -Annuity disclosures
Consumer protection and helping seniors avoid possible financial hardship is paramount to the mission of the Department of Insurance. Seniors now have more protection with the new annuity disclosure requirements provided by AB 2347. The new law requires disclosure language on the front of the policy jacket or on the cover sheet for an immediate annuity that aligns with the disclosure language already required for the more common deferred annuity products. This bill will go into effect July 1, 2015
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Westminster, CA 92683
Untied Health Care
P.O. Box 6106
Cypress, CA 90630
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