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November 2007

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Subject:
Insurance Concern: UnitedHealthcare Services Company of River Valley
From:
"W. Leroy Fanning" <[log in to unmask]>
Reply To:
W. Leroy Fanning
Date:
Tue, 6 Nov 2007 10:26:47 -0500
Content-Type:
text/plain
Parts/Attachments:
text/plain (38 lines) 
To be sure I am not one who rants very often but the manner that
UnitedHealthcare chooses to treat its valued customers needs to be
discussed.

My wife, Rita, called Dr. John D. Franklinıs office to make an appointment
yesterday after getting a referral from our primary care physician.
Although Dr. Franklinıs name appears in the new UnitedHealthcare Directory,
she was told they no longer accept UnitedHealthcare because they donıt pay
their bills.  Rita then called UnitedHealthcare to verify that Dr. Franklin
was indeed no longer a participating physician and was told that he was
still participating. After they called Dr. Franklinıs office, she was told
that indeed Dr. Franklin was no longer participating.
 
While she had the United Healthcare representative on the phone she asked
why they havenıt paid several claims filed for her and me by Dr. Bill M.
Smith (our primary care physician).  She was told the claims were not paid
because the claims were not filed correctly.  Rita asked what Dr. Smithıs
office needed to do to file them correctly.  She was told that if they were
not filed correctly the first time, they could not be corrected and our
physician would not be paid.  We would not be responsible, but the physician
would not get their money no matter what they did.  Rita asked the
representative that even if a minor mistake is made when filing a claim the
first time there is nothing that can be done to correct a mistake ­ she was
told no there was nothing that could be done.  When Rita told the
representative that she was going to make sure that everyone at UT
Chattanooga knew this information, the representative hung up on her (or for
some unknown reason the connection was disconnected).

Question: Should Employees receive this kind of treatment and should
physicians have to battle with the insurance company for fair reimbursement?

Leroy Fanning
Health and Human Performance 

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