Help with vision insurance (UHC) — miscommunication.

Post date: 2024-04-26 10:21:37

I got my vision test from a provider who was explicitly listed on my vision insurance (United HealthCare), but who denied the service. I called UHC and spoke with an agent, who called the provider, who said they did not accept UHC. The agent was mystified and told me to go ahead and pay $99 out of pocket, and they would reimburse me $99 as the provider was considered in-network.

Important note #1: I chose this provider as it was "under" Lenscrafters and right next door — convenient. Also, listed as in-network with UHC Vision.

Important note #2: I do not have UHC Dental or UHC general health insurance. Just their vision insurance.

Here is the timeline.

Early March: Called the provider to confirm insurance coverage. Was told they did not accept UHC Vision even though UHC's website listed them as in-network. Called UHC, agent called the provider and was told the same thing. As stated in the summary above, was told to pay out of pocket for $99 and that I would get the $99 reimbursed. Next day, I did so, paid $99. Frames/lens at LensCrafters were covered no problem at all.

A few days later: Called UHC and was told to fax in the receipt and explanation. Did so, called again to confirm they had received the fax. Was told yes.

Mid-March: Called to follow up. Was told they were processing it and to check back in late March.

Late March: Called in, was told to check in early April.

Early April: Called in, was told they actually never received my fax. Was placed on hold for two hours while they figured it out. Was given nonsensical answers/explanations. Finally got ahold of a supervisor, who instructed me to email her the receipt and that she would process the claim. Apparently, they never did get my original fax, even though a few agents seemed to think they did? I emailed it in and called it a day. Was told the claim clock would reset as it was considered received now.

Mid-April: Followed up with the supervisor via email asking when I should expect the $99 check. She responded, BUT it was sent in the form of a secure email form... with UHC Dental. Which I have no access to, as I am not an UHC Dental customer/member. No login information, nothing.

Emailed again, asked to send me a secure email via the UHC Vision secure email page. No response.

Today: Received a check in the mail... for $40. Apparently, UHC determined my provider to be out of network, even though they were explicitly listed as in-network and the original agent confirmed as such.

I am tired. This is ridiculous. How do I proceed? Any escalation paths? It should be worth mentioning that the UHC Vision team transferred me to the general UHC health insurance line so that was wasted time working with agents who couldn't help me, as only the UHC Vision team could. So frustrating.

I am disheartened because UHC Vision has always been my first choice, but now this happened. I have tried to be patient and had to explain the whole situation repeatedly.

Thanks.

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