UMR — claims not getting processed
I am absolutely sick of this company. I have UMR through my employer as my primary provider. I also have seconday insurance through my husband's provider. I have RA and receive infusions in my home every 8 weeks. I have had to call every single month when I receive my EOB statements. First it was the medication needed a pre-auth. All of that was done, now it's been discovered the medication doesn't need preauth, the skilled nursing does. I have called them asking for the codes that my specialty pharmacy was requesting so they could in turn give UMR the codes for the skilled nurse. UMR told me that actually neither the medication nor the skilled nurse needs preauth. Every time I have an infusion the EOB that follows always has the charge denied for the skilled nurse. And then another letter follows stating they need more information from the Specialty Pharmacy and until they are provided with that information, the claim is unpaid. I have spent so many hours trying to deal with these extremely rude, incompetent, unethical people I am fed up. I have turned this over to my HR department. I'm done.