Thursday, July 04, 2013

United Healthcare: The Saga Continues

Yep, the ridiculousness continues with United Healthcare.  Remember the allergy misery of High Hay Fever Season down here in Florida?  And remember my allergy test results (link includes pictures of my scratch-tested back and subcutaneously injected arm), where it showed I was allergic to All the Things?

You'd think I'd be an ideal candidate for allergy shots, considering that none of the standard therapies have alleviated my suffering.  And you'd be right according to all major internet sources, medical sources, and (most importantly) my freaking physicians.

But in the eyes of United Healthcare, somehow I'm still not supposed to get allergy shots.  I've heard every excuse in the book from them.

  • They've said the shots weren't medically necessary (how???)
  • They've said my doctor failed to provide the requested information in the timespan allotted (false, and my doctor has proof)
  • They've said that the problem is the date of service on the claim covers a span of days (when their own policies limit the number of units my HCP can bill for in one day)

It's absolutely absurd.  And in the meantime, I've now lost three months worth of immunotherapy thanks to United Healthcare's dithering about paying a claim for a necessary, covered service.

I have lost the time I spent driving to and from my doctor's office -- a one-hour round trip.

I have lost the money I've spent in gas doing the same -- upwards of one hundred dollars.

I have lost sleep due to moving my wake time up in order to arrive at work early so I wouldn't completely gut my sick leave with my employer.

I can't get any of these things back, the most important of which is the progress I'd made with the two months of injections I was able to have.

Oh the heck with it, I'm going to repost this picture.  Please tell me, how does a back that looks like this fail to impress upon an observer that the person tested has severe allergies?

Bear in mind that any spot where there is no visible welting was retested in a subcutaneous injection on my arm, and every. single. spot. tested. welted up.

Even if I could go back to my allergist Tuesday, it would be questionable if I could hit maintenance dose by December, which is when High Allergy Season begins for me.

So thanks United Healthcare.  Thank you for denying me a necessary covered medical service.  Thank you for interfering in my healthcare.  Thank you for condemning me to another year of misery as I try to slog through High Allergy Season 2013-2014.  Thank you for depriving Those Who Sign My Paychecks of a functional employee.  Thank you for making a profit off of my employers and others while denying me and others like me the healthcare their doctors have prescribed.

Oh, and thank you for Bernard, with whom I spoke most recently, and whose only phrase appeared to be "I couldn't say" when I asked him how to fix this situation.  Poor Bernard.  When asked if he could transfer me to someone who could say, he informed me no such person existed.  So I suppose I am to believe that the entirety of United Healthcare is staffed by incompetent, impotent idiots.

I have now filed a complaint with the Florida Department of Financial Services, am filing an grievance with United Healthcare itself (because weirdly, United Healthcare's policies still won't let me file an actual appeal), and should I fail to receive satisfaction from these filings I will also be filing with... shoot, my paperwork is at the office, but it's something like the Agency for Healthcare Administration  that handles quality of care issues for HMOs.

The sheer idiocy and complexity of this process is mindboggling.  Thank goodness I'm not trying to get help for a mental health issue... although at this point I think United Healthcare is certainly provoking an anxiety attack.  Question is, if I seek treatment for anxiety, will they cover it?

Pfft... we all know the answer :P  You just have to laugh, because screaming is too hard on the vocal chords.

Good grief.


In other news, uhm, happy 4th of July? Sheesh.  I'm going to enjoy my four days off and try not to think about this until Monday.  Take care, y'all :)


Norma said...

This is a disgrace, Amanda. I am very proud of you for hammering away at their corrupt system and I hope it proves to your satisfaction in the end. Would your employers consider switching to another provider?

Amanda said...

Thanks Norma. I hope so too.

Regarding my employers and switching to another provider, they're not yet there. But one of the partners is having difficulty with United Healthcare also (he has Crohns, which is another fun barrel of monkeys from the "get UHC to pay for covered services" perspective) so I'd say it's not out of the question.

The simple fact is that the more employees United Healthcare inconveniences, and the more people whose health United Healthcare puts at risk due their audit company's interference in the healthcare of the insured, the more open my employers become to seeking alternative insurance even if the cost is higher. My employers (and all employers who provide health insurance for their employees through this company) pay United Healthcare to keep their employees healthy and functional, not to have those same employees driven to distraction and have their health further compromised by United Healthcare's failure to pay for covered services.

Something's got to give.

Sarah Kopf said...

Unfortunately this is happening all over the country. It's disgusting. My son had cancer. Twice. And the insurance company tried telling us he didn't need certain chemos. Are you kidding?! My doctor says he DOES---so that's why I pay premiums! We ended up filing grievances until they paid. Sad.


Amanda said...

Sarah, it's lunacy for sure. I don't understand why insurance companies are allowed to make decisions about our healthcare that are in direct opposition to the treatment decisions our doctors (who have actual medical degrees!!!) have made.

It's flatly ridiculous. It's also a reason (and I know this isn't universally popular) that I believe there should be a government option for healthcare. Because battling it out in the public marketplace isn't having any good effect for the consumers at the moment; putting, say, the agency that administers Congress's healthcare program to work for the rest of the country might be helpful.

Or at least it might be entertaining. I'd like to see our elected representatives in Washington deal with what their constituents live with on a daily basis. Just stick them in my shoes for a year -- and I'm an employed, relatively healthy woman with zero debt -- and see how their tune changes.

I'm gonna shut up before I get really ticked :) Back to you and Cole, I'm glad they finally paid. An insurance company dickering over money when the life or death of a child is at stake is just beyond disgusting. You have all my sympathy :(

The Crafty Angel (aka Manicured/Headacheslayer) said...

I am both appalled and terrified. You should NOT have to put up with this bullshit. The sheer insanity of it all is just....insane.

And since I have UH I'm terrified that, as a person with multiple health conditions, I'm going to have to deal with their asshattery one of these days. I mean....ALLERGY SHOTS. It's not like you're asking for some bizarre alternative treatment in some tiny island off the coast of Fiji.

I will be praying hon, alot.

And yes they do cover anxiety @@ (that's an eyeroll at them, not you).


Amanda said...

Yeah Angel, it's not as if I'm requesting anything even vaguely controversial. I have allergies. My allergies are severe. My allergy season lasts in excess of seven months; ergo, allergy shots are my best option for relief of my symptoms.

It's not rocket science. Even Dr. Google agrees (although Dr. Google is also not in network, no doubt... *eyeroll*).

And no worries, I knew your eyeroll was for UHC and not for me :) Sad thing is, though, even if UHC claims to cover anxiety, the question is *will* they. Because remember, theoretically, they cover allergy shots too...

ShrinkingDoc said...

This is a pretty good example of why, I'm guessing, the state where this company is based, doesn't allow for-profit health insurance companies, like United Health, to insure people in the state. (Meaning pretty much no one working in Minnesota where United Health is based is insured by United Health, maybe unless their company is based elsewhere.)

I mean, all of the insurance companies have Mickey M*use rules, but this seems completely ridiculous. They're basically just hoping you'll give up and suffer and then they won't have to pay. And that's probably what most people do. And they profit.

Amanda said...

Bingo, Doc -- you nailed it. Unfortunately for United Healthcare, my experience over the past few allergy seasons and watching how my reactions have ratcheted up on an annual basis means I'm deadly determined to get these shots. I went from just having to take Benadryl here and there, to having to take a daily allergy medicine in 2010-2011, to having to take a daily allergy medicine and antihistamine eye drops in 2011-2012, to having to take a daily allergy medicine and steroid eye drops in 2012-2013 just to be on the edge of functional.

The thought of the approaching high allergy season for me (which begins in December) without these allergy shots is really unnerving, because at this point I have no other recourse but the shots. My reactions are only going to become more severe.

So yes, I'll fight this to whatever level necessary. I cannot go through another allergy season on the level or worse than the one I just went through. I'm truly afraid I'll damage my eyes with the way I wake up scratching them.

I'm so sickened by this.

ShrinkingDoc said...

Keep on keeping on, girl! Don't let them keep you from getting what you need!