Re: Stupid UHC - external appeal?

[Guest guest]

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I'd wait for Marci to reply, but I personally would just go with the DOI. Why waste anymore time with the UHC goons???

Kendra

Stupid UHC - external appeal?

Okay, what should I do?I think you are all quite aware of my problems with United Healthcare. They denied us because our policy doesn't cover orthotics. I got a letter 3/18 telling me I had 8 days to request a face to face appeal. A letter was faxed that day. 4/19 I called to see what was going on. They claimed they never got the request. They told me it was passed the deadline I basically I was screwed. I called back and was told if I faxed another letter that day that it would be okay. I did this. A couple of days ago I called to see what was taking so long. I was told that the fax was never received (I even got a confirmation call when the lady got the fax). I then filed a complaint with the Ohio Dept of Insurance and requested an external review. Today I got a packet from UHC that my face to face appeal is 5/8. The right hand doesn't know what the left hand is doing! It included my file with this claim. Of course all of the stuff from StraightAhead (CT) is not included at all! I had that couriered down and it was signed for. The courier company is pulling the manifest for me to include in my complaint. What giant jerks. My question is this: Do I waste my time with a face to face appeal or should I go right to the external review? The letter I got from them said I could do it over the phone and fax them all the info. That sounds pretty nice, but how in the world can I have a rational call with these jerks when I am taking care of 2 kids? You know someone is going to get fussy or poop during that time. I am so sick of them. I feel like just continuing through the DOI. The denial letter I got from UHC said that I could just go to the DOI.Help! Thanks, Dane's mom (DOC Band)Oh yeah! The letter they sent is dated April 19 and it wasn't mailed until April 30. Could you imagine being that inefficient?For more plagio info

[Guest guest]

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Jeez - what a bunch of MAJOR knuckleheads!!! I cannot believe the stupidity that

must be running that joint. Keep a sample of absolutely EVERYTHING!!! Document

the miscommunications as thoroughly as you can and keep a detailed phone log if

you are not already doing this. You will probably have to go through the final

appeal process before the DOI or an external review board will get involved. It

doesn't hurt that you have already filed a complaint with the DOI, but it is

possible that they will come back to you with a " contact us again after the

appeals process is over " response. The external review will not be conducted

until the appeals process is complete. After the final face-to-face then you can

go with the external review (if you have to).

Hope this helps - good luck and keep after girl!! With the run around you have

been given and the documentation you have been keeping you should be able to do

well with the DOI and/or the external review board.

Marci (Mom to )

Oklahoma