After, lo, these many painful hours of dealing with UHC, I’m ready to share my knowledge.
When calling, after you enter your subscriber number and date of birth, say “representative” if you want to talk to a person. When you are on hold, if you say "shut up" the recording will stop telling you about their worthless web site. You may need to say it a few times. Forcefully.
If the person on the phone can’t help you, ask for a “rapid resolution specialist.” They can fix things the Tier One people can’t. And they won’t tell you the magic phrase (“rapid resolution specialist”) until you’ve wasted hours of your life. If they don't want to pass you on, just keep using the magic phrase: "I'd like to speak with a rapid resolution specialist.”
If you have an ongoing complicated case, ask to be assigned a “care coordination case number.” It probably won’t help, but it’s worth a shot.
If you want them to cover an out-of-network provider at the in-network level, you need a "gap exception" -- another magic phrase they won't tell you about. If you are lucky enough to get a gap exception, make sure you take the reference number to your provider! UHC won't do that for you, so you'll continue to be billed at the out-of-network rate.
When faxing, don’t bother. You can fax and fax and fax, even “to the attention of” someone’s name, and they will claim it didn’t arrive or is illegible.
Just now I found the Patient Advocate Foundation. They list all the State Insurance Commissioners Offices contact info, which probably would be worth a try if you have been trying to get UHC to cough up for a few months without any resolution in sight.
If you have any tips, please post a comment! If any of these tips help you, please shop Amazon through my link. All proceeds go to charity.
