I am freaking LIVID.
My allergy shots are suspended until further notice. United Healthcare chose my account to audit with the allergist and their auditing company has determined that United Healthcare shouldn't pay for the vials of serum I receive in my shots because none of my appointments in the records my doctor's office sent over correspond with the 4/1/13 date of service on the claim for the serum.
In other words, the auditor doesn't understand that "date of service" in this case corresponds to the formulation of the serum for my shots, not a patient appointment.
I am in touch with my local insurance folks' office and they're in contact with their UHC person, so we'll see how this goes from there. Thus far UHC has told my insurance brokerage that the claim was denied because "we didn't get the records we requested in a timely manner" while at the same time they're telling the doctor's office those same records (that they supposedly didn't receive) don't correspond with a patient visit when the charge wasn't for a patient visit in the first place.
The mind boggles.
Weirdly, UHC has no problem paying for the injections themselves. They're also fine paying for my visits to receive them. They just don't want to pay for the shot contents…
I'm going to go off and beat my head against a wall while I try to get this situation resolved. And people don't think there's a healthcare crisis in this country? Really?
United Healthcare, my office pays in excess of... well, an amount I won't go into here. But suffice it to say, they pay a HUGE amount of money to insure us all. They did so even prior to the ACA. Stop playing games with my health.
Earlier this allergy season I was in absolute misery. From December through early January I was literally near scratching my eyes out, despite the use of Zyrtec, Benadryl, Zaditor (OTC eyedrops)... nothing worked. Patanol (prescription antihistime eye drops) caused a reaction whereby the itchiness of my eyes was exacerbated. The only relief I got was from Alrex, a lovely prescription steroid eye drop.
Problem there? Extended use causes glaucoma (and my genetics already swing me that way) and can drive up the age at which those prone to cataracts will develop them by 10 years.
Yes, I'm also genetically predisposed to developing cataracts, so lovely. Sigh.
I went to an allergist, and considering my symptoms, the fact that they've become impossible to control even with standard prescription intervention, my minimum 7-month allergy season, and the fact that I reacted to All The Things on the allergy test, it was determined that allergy shots (immunotherapy) were my best bet.
Now I can't even get that, because some auditor is too thick to understand that "date of service" need not coincide with a patient visit.
This is flatly ridiculous. I'm so angry and upset I'm literally shaking.
Thanks, United Healthcare. Thanks for condemning me to an even worse allergy season this upcoming winter. I'll think of you when I'm sitting on my hands trying not to rip my eyes from my skull.