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United Health Care / Fsa Provider / will not reimburse fsa funds

United States Review updated:

I submitted a faxed request for reimbursement of a dental bill to United Health Care on December 30, 2010. My fax was acknowledged. When we did not receive reimbursement, I faxed the request and all documentation a 2nd time on January 24, 2011 (acknowledgement received). I checked the website and on January 28th and there was no documenation on the receipt of my request, so I faxed a letter and all documentation to the attention of an account manager on January 28, 2011, and again rcvd acknowledgement of receipt. Still no response. I called on February 3, 2011, and after waiting for a long period of time, I was allowed to speak with an account specialist. He (Richard) told me his our request had been denied as it appeared to be a duplicate request, but that appeared to be a mistake and he would escalate payment to us and we should have the money in our account with in 7 days. I asked him why it takes so long to put money in our account (my current flexible spending plan does it the next day). Not sure if that upset him or the fact that I voiced my opinion on not letting a person know if they are denying their claim, so that I would continue to send faxes with no response, , but found out today, he did not even bother to put notes in our file about his conversation with me. On February 9th, 2011, I called and spoke with Rosemary A (thought she was an account specialist, but apparently not, as she could not authorize immeidate payment). After I had spend another half hour on the phone with them, I was a little upset and advised I wanted a check overnighted to us, as it was uncalled for to wait this long for reimbursement of $132.00. She told me she would have this escalated and account manager would call me this morning. No call ever came. I called againt this afernoon and spoke with Sharon, who had advised me that Rosemary did not bother to escalate my request. I advised I was not hanging up until I spoke with someone that could help me because after waiting on hold for 30 minutes, she told me that our claim had been denied as a duplicate. She said that is not going to happen. I was so upset I hung up. It should not be this difficult to get the last of our funds out of this FSA account. *****This company has by far-----the worst customer service I have ever seen. They must have outrageous phone bills for the amount of time they make people hold on the line. Would never recommend them**************

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Comments

  • Po
      Feb 14, 2011

    Long Story - bottom line the refused to approve, deny, review, process or even long at some of my claims or reimburse me my funds held throught USPS FSA with them. Two conversations with customer service reps. one with resolution rep. two supervisor reps.
    None will to even entertain the idea of looking at my claims - said I just have to resubmitt. Terrible and unjust!

    0 Votes
  • Me
      Mar 21, 2011

    I faxed two FSA claim forms on 2/14/2011 - one for a single dentist co-pay of $35 and another for multiple prescription payments totaling $130. I followed all of the instructions on what and how to submit FSA reimbursement claims and tripled checked before I faxed it over. After several calls and several explanations weeks later of how they have been backed up due to an internal systems error, I finally received an EFT payment on 3/9/2011 for only $35. I just called today about the other payment and was told it was still being processed and it was taking longer to ensure no duplicates were submitted; keep in mind, I only faxed the two forms over once. My response was that it clearly gives the prescription number with different dates (monthly birth control prescriptions and other primary care co-payments) and I don't understand why it isn't clearer to the processor. Today, this last customer service representative was very dry and unmoved. I am so completely agitated with their abilities or lack of resources to process claims timely. Their reasoning for the delay is an internal matter that should not concern their customers or how they conduct business; there should be a contingency plan in place if they have experienced this problem since 1/1/2011. United Healthcare should address their internal issue and not just regurgitate the same excuse over and over again to their concerned customers. Their website (myuhc.com) is a joke that does not give real-time, let alone, up-to-date information on processed claims for reimbursement and those claims that were paid for by a Health Care Spending Card. I am so disappointed that my company has elected this non-customer centric organization as a FSA administrator. I have $3, 600 set aside this year in my FSA and I am dreading future claims that cannot be paid for with the spending card.

    0 Votes
  • Fe
      Mar 21, 2011

    I've had a terrible experience with United Healthcare flex spending as well. I submitted a claim on 2/16. It's still not showing on their online system. I've called 3 times - waited the full amount of business days that they said it would take to process. I'm hearing the same excuse - that it was denied as a duplicate due to the same claim $ amount. So ridiculous. My sons monthly tuition is the same - of course the claims are going to be for the same $ amount. This was the first claim for 2011. No way it could be a duplicate. I've complained to my HR department - I don't know what else to do at this point.

    0 Votes
  • Mi
      Apr 12, 2011

    My company switched to UHC for FSA last year. Prior to August 2010 claims were processed fairly quickly. Since than I found it normal to take up to 6 weeks. Last year the excuses I received were everything from system changes to backlogs. Now in 2011 I submitted my first claim on 2-11 and have yet to see the money appear in my account or any type of status on their website. And once again, hearing the same excuses. It's utterly ridiculus! How can they hold our money hostage?? How can we get our claims paid??? I'm so frustrated with the whole thing I'm not sure if it's worth the savings.

    0 Votes
  • Fe
      Apr 12, 2011

    So, just as a followup to my complaint. I notified my HR department and opened up a complaint with them. They contacted UHC directly and were able to get this resolved. I have no doubt that if I had not gotten my HR department involved - I would still be waiting.

    +1 Votes
  • Fr
      May 05, 2011

    I ABSOLUTELY agree with everyone who has issues with UHC. I have had to process UHC FSA dependent childcare claims for two years. Their most recent "excuse" (April 2011) is that their internal software system went "down" and now instead of taking 10 business days to process claims it will take 22-25 business days. My issue with this is that they are holding my money and EARNING nightly interest on my money. Come on you are one of the largest healthcare companies - you don't have a back up system when you a software malfunction? I would never recommend UHC to anyone - and I never want to be transferred to another "rapid resolution specialist" who really isn't rapid or resolution focused at all. Come UHC...get your crap together...

    0 Votes
  • Ki
      May 13, 2011

    I submitted a Dependent care reimbursement claim on 18-Mar-2011. After 10 days of no activity listed in my online account, I called to request status. They stated there was no receipt of the claim. So I refaxed on 28-Mar-2011, made a follow up call on 30-Mar-11 only to find out they are still denying receiving the form. Five separate faxes were sent and finally acknowledgement of receipt is provided; however, the date of acknowledgement is now 5-Apr-11 which is 5 days after the cut off time for submitting claims. All five confirmation pages from the fax machines were submitted as proof of submission and UHC is still denying the claim! My next three phone calls made appeared to be no issue with UHC, as all 3 reps said it is being sent back for processing since the fax receipts were provided. I have spoken with the "rapid resolution team" and another "speciality department" 6 times through 13-May-11 to no avail. Now I am being told they cannot release the funds because they no longer have access to them, with a second story that the IRS won't allow the processing due to time constraints! I've contacted my HR for assistance and am extremely pissed, putting it lightly. I have never had such poor service with any insurance company before and there should penalties for companies who handle employee's money in this fashion. NEVER USE UHC FOR FSA REIMBURSEMENT!!!

    0 Votes
  • Sr
      May 13, 2011

    just stay on them period if you sit back and think oh there working on it NO it will never get resloved you have to hound them daily i work with dental insurance and its a nightmare sometimes the insur. comp wont even tell us if the person has coverage or not we'll send in the claim 2 months goes by you call them and they act all stupid like "oh we never rec. it" or you spelled the patients name wrong just stupid things like that its a shame and horrible how insurance companies are allowed to run its horrible and not fair!! like i said keep calling get crazy on the phone it sounds bad but its the only way!

    0 Votes
  • Fe
      Jun 02, 2011

    I realize that we all get some relief from writing complaints here, but does anything really come from it? Is this just a place where we can see that I am not alone in this struggle. I have been waiting 4 months, 3 phone calls, 3 submissions. Who can we really complain to and get results. I see where someone writes 'never use uhc for fsa reimbursement'. Thats well and good, but I for one, do not have a choice; it's what my employer has picked. Good luck to all (apparently thats what it takes cause it sure isn't competency on their part).

    0 Votes
  • Ja
      Jun 03, 2011

    I think they use different excuses for different customers; until a coule of weeks ago, they have been telling us that they've been taking care of the claims from last year and that is why I have to wait. My first claim this year took nearly two months to be processed. Also they keep denying everything, stating they are duplicates, when all the receipts have different names (because they are for 4 family members). I just got off the phone with them again and their new excuse is their system glitch in April. I wonder if they know it is 3'rd of June, not April anymore. When we called yesterday, we learned that they denied our last claim for $25 (co-pay for ultrasound), stating it's a duplicate (because we had another claim for a doctor visit, 10 days before this one, which has a different date & time on the receipt with the same amount). They said it was computer's fault. Come on! Same doctor, but two different dates, one is for doctor visit co-pay & another is ultrasound co-pay, clearly written on the receipts, 10 dates apart; do they really think I will believe their excuse. I had to file a Better Business Bureau claim to get some of my claims processed earlier this year at United Healthcare-FSA and I guess I have to file another BBB claim to get the rest of my money. Or, contact another agency who might check them out to see what is taking so long. Last year they used to process every claim in 1-2 business days and it took another 1-2 business days for the money to be deposited to my account. In short, they used to do this in 3-5 business days total. There has to be a way to get them to do their job right. DOES ANYONE KNOW ANY AGENCY WHO ARE IN CHARGE OF UNITED HEALTHCARE-FLEXIBLE SPENDING ACCOUNT?

    0 Votes
  • Jb
      Jun 10, 2011

    what you may not realize is that due to one year ending and a new one beginning, everyone that has an FSA account is submitting claims. as you should know, FSA is use it or lose it. everyone is getting those final claims in which is the reason for the 22 business days. plus, now that everyones accounts have been refilled with money because of the new year starting, eveyone is getting claims in to use it.
    these claims have to be entered in by hand. they are entered in the order they are recieved. think about how many people in the country have these accounts. especially how many are being recieved at one time for october-april timeframe

    0 Votes
  • Fe
      Jun 10, 2011

    I completely disagree jbfirebird - this is nothing new. This is a seasonal occurrence. They need to staff their business appropriately to handle this. It's June - halfway through the year. Not seeing it get any better.

    -1 Votes
  • Jb
      Jun 10, 2011

    your right. it isnt anything new. but it still normally takes 10 business days to do it if there wasnt a backup of claims. right now, there isnt a backup. so, the normal 10 bd applies. you wont be getting paid from any fsa/hra immediately. it sure would be nice, but regardless of the insurance, it wont happen. claims have to get entered in by a human then it processes by the system after its entered.

    +1 Votes
  • Ja
      Jun 10, 2011

    When reading all your replies, it seems like you are working for the United Healthcare "jbfirebird". If a company like UHC can't manage their company/staff/workload, it is not our fault. I had Flexible Account with them last year and all my claims were done & paid in 5 business days most, which means it can be done. You are talking about how they have to process last year's claims first: I did all my claims & got reimbursed by December 31'st. Since this is the new year, UHC should hire a handful of employees just for the last year's claims, so others can process this year's to not cause any more delays. I never had to re-fax my paperwork last year; this year I was told by their own employees that how some of their staff made a mistake processing my fax/claim and how I have to re-fax it and how it would cause additional 10-15 business days of delay. What? Are you kidding me? They make the mistake and they expect me to be patient & understanding about having to wait even longer, so I can get my hard earned money reimbursed. You are talking about how they have to enter the claims in by hand; well if they pay attention to what they are doing, they might do it right the first time, so people like us don't have to wait months to get their money back. So far, they rejected some of my claims, stating it was a duplicate (when all my claims, receipts had different names as a patient, plus in some cases completely different dates), they denied some of them, stating it had a future date on the claim (and their processing date was a later date than the actual service date, which means it was already in the past), and their latest excuse is this: Our system has a problem that is causing for the claims to be in the "processing" status and not letting us pay for it. Really? What a relief to know that all their problems are caused by computers and the people who are doing their claims from last year and never by the United Healthcare employees. All my latest claims just sitting there, showing payment sent, but no date for the payment, which means UHC is stting on my money, earning interest, while I am suffering with my family. I know for sure that I am never having another FSA, if UHC is doing it. Having a Flexible Spending Account suppose to be convenient for the customer, not another hassle they need in their lives!!!

    -1 Votes
  • Br
      Nov 30, 2011

    YES to all of the above. United Healthcare FSA is terrible. I've used Key Companies with my employer for years, which (with rare exception) distributed FSA funds in a timely and predictable fashion. I switched to the UHC FSA through my husband's employment this year. They take months to pay, they don't notify me when there are disputed claims, the fax numbers for submitting claims don't work, and the customer service is a major hassle. We're no longer covered by UHC, thank God. (On a separate issue: I'm participating in a class action suit against UHC, which I hope will recoup half of my emergency room bill following an auto crash, which they refused to pay in full because the hospital was not "in network." Unfortunately, the ambulance driver didn't ask me whether the closest hospital was in network. Sheesh! We need universal health care. Cut these guys off!)

    0 Votes
  • Me
      Sep 05, 2012

    I will never again get a fsa thru uhc, ever... I just learned they have it set up automatically so when i go to a doctor or buy rx out of my own pocket, they are still Billing my fsa!!! I only set money aside in a fsa for dentist for my son. I call for info today and find out my fsa is maxed out! I an being reimbursed for all these things billed to the fsa, now i have to Wait for the checks so my son can go to the dentist. Thus complaint does not do thus justice, but i am ticked right now. I have a credit card to use for my fsa, why if the fsa is going to pay for whatever they want without my approval??? In a month they billed $700 to my fsa that i was not even aware of. Insane.

    0 Votes
  • Co
      May 13, 2013

    I have had nothing but challenges from FSA Claims submission to UHC. My latest issue was on 5/2/13 when I submitted for $324 and only got $274 back. I called today to find out why and I was told one claim receipt for $25 was illegible, but there was a unique receipt number on it. I was also told that one of my 2 pages of documentation for a $25 receipt was not legible, but everything they needed to reimburse was on the first page. Had the processor used common sense, the entire claim would have been paid. After expressing my frustration to the cust svc rep I got a supv who said yes I should have been reimbursed since the documentation received was sufficient. Additionally, one of the rejection reasons was insufficient funds in account, which the cust svc rep confirmed was not true. I have had continual problems with UHC's FSA claims processing. I am going to writing a formal to complaint and if I am still getting poor service, I will be in touch the Attorney general of NC and of TX where they are located. You should not have to go through such work to get reimbursement of your own money -- this is simply absurd.

    0 Votes
  • Ga
      Feb 17, 2014

    I submitted a claim reimbursement for $254 on 12/16/13 for a claim that was on 1/10/13. I submitted this using their on-line system (I have a copy) and they claimed they never got it. I re-submitted this on 1/21/2014 via fax. Today, 2/17/14, they informed me my claim was denied but never sent anything stating that. Their reason for denying the claim was that I was not covered by the FSA until 1/16/13, the card was printed on 1/15/13, and I enrolled as of 1/1/13. I should have been covered the whole year but a year later, the lost my claim and denied my claim without notification so that I couldn't even use my remaining FSA dollars. This is a shady practice by UHC.

    0 Votes
  • Fr
      Mar 19, 2014

    I have been using UHC for years now and have received the same explanations: we did not receive your claim, the copies submitted are unreadable, IRS requirements, duplicate claim (when additional UHC documentation is submitted), etc., on and on and so forth. As a participant to my employer provided program I can not choose any other service provider. UHC needs to be FIRED. They are not capable of processing a claim efficiently without numerous submissions and hours of phone calls to straighten out their internal miscommunication. Mind you, they are scattered out across the continental US and can only answer your questions with info provided on their computer screens. If the info isn't on screen then you have not provided what is needed. Regardless of how many times you submit the claim with supporting documentation. If it were possible for me to get rid of UHC it would have taken place years ago. This is all about money and they will try to frustrate and delay you until you give up. This in turn is where they make money. Don't give up, prepare yourself each year for the never ending submissions and phone calls.

    0 Votes
  • Fr
      Dec 23, 2014

    Wow, wish I could've seen these complaints before signing up through my employer for the dependent care FSA. We recently switched from another provider that has been nothing but great for the past 3 years! This plan started in October, and they have yet to pay a claim for child care, they keep saying there is a system malfunction and that they'e working on it. This is absolutely ridiculous, they're holding my money hostage!! All the while I'm paying nearly double for childcare, between what comes out of my biweekly paychecks, and weekly childcare tuition! Had I known it was going to be this much hassle to get reimbursed for our childcare expenses I would've never signed up for this plan!

    0 Votes
  • Ci
      Jun 17, 2016

    I submitted a Dependent care reimbursement claim on 17th Mar 2016 by post, My only mistake was of not sending it by registered post and simply dropped my claims documents in the USPS mail box outside my apartment. when I called UHC on 7th April 2016 they denied receiving my claim documents and said that they have not yet received any. So I insisted talking to the supervisor and then was directed to the person in charge one Mr. Brian who then gave me a fax number where I could fax my documents again. I had to call UHC continuously to confirm if they received my Fax. After that I received a letter from UHC saying that they have denied my claims and I could appeal again if I want to. I then appealed again and they denied it second time. Now I have received another mail denying the claim and suggesting that I can appeal for the third and last time if wanted to. I am not sure as I have tried connecting to my HR department and they got an excuse from UHC stating that its IRS guidelines that they could not pay my claims and cannot do anything more to help. The amount here is very large and I don’t want to lose it as I am working hard to pay check to paycheck with my daughter and was looking forward for this money to pay some of my bills. This is ridiculous as I had sent the documents on time what happens at the post office is not within my control. Despite that UHC has a heart to deny my legitimate claim. I feel cheated by them as i am following to claim my money, my hard earned money that UHC is refusing to give back. Please advise what should I do.

    0 Votes

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