UnitedHealthcare Deletes Incriminating Chat

[u/One_Combination5776]

I had a certain medical appointment. I used the chat function about a month ago to verify that it was covered and what my out of pocket total would be. I provided all information such as facility name, address, Tax ID, and NPI number. They explicitly said that it is in network, is covered, and what the total is.

Fast forward a month and it was NOT covered. I knew someone somewhere told me it was but forgot who I talked to. I then scrolled up and saw it was in this chat that I verified the confirmation. I took pictures of the chat on my phone and called them out, telling them they told me in the chat it’s covered. I will have to have the medical office re-submit to insurance under a different code or something.

I then went back to look at those messages where they claimed to cover it. They were GONE. Just 30 minutes later. They weren’t the oldest or newest messages. Right in the middle. Messages before and after were still there.

I then called them out saying those messages are gone and I have screenshots proving they said the appointment is covered. And guess what, they are back an hour later.

I checked through the chat over and over to make sure my eyes were not deceiving me and that I wasn’t crazy. I also had my wife verify too.

I truly believed they made that section of the chat not visible to me, so I wouldn’t have proof of them saying it’s covered. Once I called them out and said I have proof, they brought it back. The coincidence is too large.

Has this happened to anyone else? Is this something they can do?

[u/msp_ryno]

NOTHING IS EVER A GUARANTEE OF PAYMENT. They will tell you that expressly.

[u/One_Combination5776 → u/msp_ryno]

Separate question. What if you need an extremely expensive surgery. Can you ever be 100% guaranteed that something is covered? This event wasn’t that costly but what if you expect a $100k surgery to be covered and then it isn’t?

[u/Knitwitty66 → u/One_Combination5776]

That's the fun part of American medicine and insurance. You get an operation to fix a painful problem, and they tell you it's covered, but you don't find out until you're home from the hospital that Oopsy, it's actually not covered. And you've signed paperwork at the hospital agreeing to pay what the insurance doesn't.

There's nothing else we buy that this is allowed. I have put off tests that I need to have done because I have UH and I'm afraid they're going to pull this same garbage.

[u/skydreamer303 → u/Knitwitty66]

This. My insurance swore up down and sideways they would pay for my jaw surgery. They paid for the one night hospital stay...I got stuck with 30k surgeon fees 🥲

[u/YogurtclosetOpen3567 → u/skydreamer303]

Did you appeal? That sounds liken a strange denial

[u/skydreamer303 → u/YogurtclosetOpen3567]

Yes. Multiple times. Got fucked. Its pretty common for this type of surgery. They couldnt explain to me why they would cover the hospital stay for said surgery but not the surgery itself.

[u/YogurtclosetOpen3567 → u/skydreamer303]

Did you look at the EOB, was it because of our of network or medical nessecity because in some cases you have the right to an independent reviewer

[u/skydreamer303 → u/YogurtclosetOpen3567]

Yes, every jaw surgeron is OOO for most insurances. At the time I had UHC and filed for gap exception which is the only reason they even paid for the hospital bill. They did not cover a single surgeon In network.

[u/YogurtclosetOpen3567 → u/skydreamer303]

Wait and then what did you do when they denied it? Once you exhausted the appeals

[u/skydreamer303 → u/YogurtclosetOpen3567]

I ran out of appeals then had to use a credit card to pay for it? it is 0% APR at least

[u/YogurtclosetOpen3567 → u/skydreamer303]

Wait so did you pay it ahead of time or after time, and why did the deny the appeal? Did the doctor try to help at all??

[u/skydreamer303 → u/YogurtclosetOpen3567]

you have to pay ahead of the surgery and they are supposed to reimburse you after.

[u/YogurtclosetOpen3567 → u/skydreamer303]

That's unusual some agreements vary in that

[u/Savingskitty → u/skydreamer303]

That is insane.