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/[deleted] → u/One_Combination5776]

That would be what pre-authorization is for… you don’t seem well educated on this topic.

It seems as though you misrepresented the nature of the conversation, you admit that they didn’t guarantee it would be covered, because that’s by default a boiler plate policy.

Good luck in life with this mentality.

No one is wasting time deleting chats at a $100 billion+ market cap company over such a pittance of money.

Basic logic. It was denied, you accept it was denied, you admit you should have known it wasn’t a guarantee. What would the result of having the message be? You still being denied.

Grow up.

If the messages were deleted it’s because of a data retention policy as you gave personally identifiable information.

[u/JKTX30 → u/[deleted]]

UHC has entered the chat

For real though-- They are saying the have run into situations where they received a prior authorization yet insurance still refused to pay, and were told by insurance that even a prior authorization is no guarantee of payment. Unfortunately this kind of dishonesty is all too common in the insurance world so don't just try to discount everything people are telling you about their actual experience just because you haven't had the same experience yet

[u/[deleted] → u/JKTX30]

Who is They?

Most of your response was garbled, meandering, and barely intelligible. Are you drunk?

[u/WorryFar7682 → u/[deleted]]

AI is employed throughout the system. Not just the deliberate rigged claims processing that is skewed against the member. They don’t need a person to do it, it’s written into code and deployed.

[u/[deleted] → u/WorryFar7682]

Some forms of AI will help the medical system. Good example below that improves claims for lower denial rates.

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