Post by @Brad_Rosenheim@climatejustice.social

@Brad_Rosenheim@climatejustice.social last week

My wife is on the phone with #UnitedHealthcare because a surgery she had scheduled for Tuesday next week was denied by the insurance company. The woman who is speaking to her has informed her that there is a nursing support call that is free of charge if my wife needs to discuss the emotions of getting this claim denied and to plan future care. It is such bollocks. USians generally hate our healthcare plans and these companies. Imagine facing surgery and being told that they won't pay for it, but they will pay for a nurse to call you and console you about their decision. Absolutely horrific.

Oh, and I pay over $3,000 per year for this level of health insurance for my family.

#USHealthcare
#PrivateInsurance
#MedicalCare
#medicine
#surgery
#healthcare
#insurance

#privateinsurance #medicalcare #ushealthcare #unitedhealthcare #surgery #medicine #insurance #healthcare

10 Replies

0 Boosts

diana 🏳️‍⚧️🦋🌱

@dianea@lgbtqia.space last week

@Brad_Rosenheim

I knew a sociopath that worked for UHC. That person would brag in detail about denying claims over the phone and how they dropped the voice a few octaves to fake being their own supervisor.

The only recourse that I know is to find a patient advocate with experience in the medical care field that will effectively do the legal work to get your coverage approved.

MissConstrue

@MissConstrue@mefi.social last week

@dianea @Brad_Rosenheim

Patient Advocate Foundation (PAF): A national nonprofit providing free case management for patients with insurance denials, coverage disputes, or large medical debts, particularly those with chronic conditions.

Hospital-Based Advocates: Ask for a patient representative, social worker, or financial counselor at the hospital where you receive care; these services are often free but limited to that facility.

For comprehensive, undivided loyalty, search directories like the National Association of Healthcare Advocacy (NAHAC) or the Alliance of Professional Health Advocates. These professionals may charge hourly fees or contingency rates.

Check your Medicare Advantage plan or employer’s Employee Assistance Program (EAP) for included care coordination or case management services.

Federation Bot

@Federation_Bot last week

@dianea @Brad_Rosenheim

Hospital-Based Advocates: Ask for a patient representative, social worker, or financial counselor at the hospital where you receive care; these services are often free but limited to that facility.

Check your Medicare Advantage plan or employer’s Employee Assistance Program (EAP) for included care coordination or case management services.

Norcal Gma 2

@NorcalGma2@sfba.social last week

@Brad_Rosenheim
I am so sorry.
I am fighting for surgery for my husband too.

Brad Rosenheim

@Brad_Rosenheim@climatejustice.social last week

@NorcalGma2 Sorry to hear that. I had read your post about Summer reacting to your husband's voice when he called home, but did not realize that the hold up was insurance. We are hoping they cover it for him! For my wife, it seems like a long battle with insurance ahead. They had a conference with her doctor on Friday afternoon and they have decided to still deny it. The doctor has never seen this and has done hundreds of these surgeries.

Norcal Gma 2

@NorcalGma2@sfba.social last week

@Brad_Rosenheim
It's not insurance but similar. He is covered by the VA which doesn't cover the surgeon he needs. They would send him to another doctor, who isn't familiar with him, at another hospital. Until we get everyone on the same page we can't get him transferred. We have to get his infection under control here at our local hospital too. I am doing everything I can to advocate for the best surgical options for him.
This is all beyond stressful and doesn't need to be so difficult.
I wish you all well in getting a better outcome from your insurance.

Come On Giant Asteroid!

@VE2UWY@mastodon.radio last week

@NorcalGma2 @Brad_Rosenheim

Hang in there. We’re all pulling for you from afar. ❤️

Aral Balkan

@aral@mastodon.ar.al last week

@Brad_Rosenheim @darthsandwich I’m so sorry, Brad. It’s inhumane and unconscionable. Capitalism is cancer. Sending you both all my love.

Reject Fascism

@PattyHanson@mastodon.social last week

@Brad_Rosenheim I'm sure you've received all sorts of advice, from a former billing & coding person, she needs to ask for
1) the name & credentials of the person who reviewed & denied the authorization & on what grounds
2) the denial in writing, specifying the justification for the denial, code by code
3) the page number in her benefits & coverage book indicating the planned procedure is not a covered benefit

Then follow up the phone call with a certified letter signature required to dept head

Skean Harshly KC1WKV

@dandrumheller@mstdn.social last week

@PattyHanson

Thank you for this advice. As another future victim of this insurance provider (I get to pay about $6k in family premium, yay) I appreciate it. Have not been denied for a surgery (haven't needed one yet) but have struggled though a couple of medication denials is good to know what to ask for.

Have also been offered the nurse line I think because my daughter had a couple of ER visits back to back - I thought it was some kind of scam at first fishing for info.

@Brad_Rosenheim