SUBMIT A COMPLAINT

UMR (a UnitedHealthCare Company, Salt Lake City, UT)insurance coverage

1

UMR did dishonest business with my insurance coverage.

I had an Emergency Room visit with WakeMed hospital at the night of January of 2012. I had serious vomit and dizzying (cannot stand and walk) and the doctor requested a CT exam.

According to my insurance plan the insurance should cover 80% (($3, 647. On UMR_Med_policy, page 4), But UMR sent me an EOB Notice on 3/29/2012 which stated UMR covering 70% of the cost. That is, UMR covered 10% ($456) less.

I called UMR 6 times in April and May 2012, but UMR kept lying and did not change to the 80% coverage:

• I talked with Charles of UMR on April 30, 2012. Charles said WakeMed is not in Network and so the plan covered 70%. I told him it is not true, the website do show that WakeMed is in Network.

• I talked UMR with Shannon and others on 5/16/2012. They were lying with a new excuse that was different from Charles. They told me that UMR covered 70% is due to it was “Non-True Emergency”. That was totally lying. The Emergency visit was truly emergence and I have the medical records.

Cindy

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