UnitedHealth Group

I am rejecting this response because:To date there has been no resolution. Furthermore, no one has contacted me like this statement indicates they would do.  The last time I called I was told by one OptumRX representative that my plan qualifies for tier reduction but that tier reduction is not allowed for Synthroid. Since not one single representative had claimed this previously, I asked for some sort of documentation of this, such as a policy showing this information.  The representative said I would have to call United Healthcare for that.  I called and spoke with a supervisor at UHC, LaRhea B and she stated she did not know if it was true or not that Synthroid didn't qualify for tier reduction, but she would look into it for me and get back to me.  She said she thought there were some people she could contact to find out the answer or who at least could tell her who she needed to contact to find out.  It seems that no one in the company knows how to handle this very simple request from my doctor or even who actually handles it or where to find the documentation advising them how to handle it. I have been bounced back and forth between UHC and OptumRx numerous times.  I was glad when LaRhea stated she would take it upon herself to get a real answer for me.  However, we last spoke February 13, 2018, and I have not heard from her since.No one whatsoever has contacted me in response to this Revdex.com complaint like they stated in this response that they would.  This is something that should have been handled quite quickly and easily, and there is still absolutely no resolution.  Under my previous prescription coverage when my doctor requested a tier reduction for Synthroid, it was handled immediately. This is a medication I take daily. This is completely unacceptable that UHC and Optum RX are so incompetent that they cannot handle a simple request regarding an extremely common daily medication.  It is either an unbelievably extreme level of incompetence or a blatant willful attempt at improperly denying requests, both of which are entirely unacceptable.

Initial Business Response /* (1000, 5, 2016/01/26) */
January 26, 2016
Revdex.com
Attn: [redacted] XXXXX

RE: [redacted] :
Dear Ms. [redacted]
I am responding to your recent correspondence dated January 25, 2016, ...

regarding [redacted].
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description of the complaint, we will respond directly to this member regarding this issue.
Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at XXX-XXX-XXXX ext XXXXXXX.
Sincerely,

Jeff [redacted]
Consumer Affairs Advocate

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. Well, no exactly. It looks like United Health will not deal with the Revdex.com. I would like to keep my options open in terms of getting help from you if I need it. United Health has not helped me yet and I don't expect they will now.Thank you

Initial Business Response /* (1000, 5, 2016/02/02) */
February 2, 2016
RE: [redacted]:
Dear [redacted]:
I am responding to your recent correspondence dated February 2, 2016, regarding [redacted].
Due to the protections of the Health Insurance Portability and Accountability...

Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description of the issue, we will be responding directly to the enrollee.
Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at [redacted] ext. [redacted]
Sincerely,
Jenna B.
Consumer Affairs Advocate
Initial Consumer Rebuttal /* (3000, 8, 2016/02/12) */
Per phone call with the consumer: "we have yet to receive a response from the business regarding our case. Please ask them to respond to us directly."
Final Business Response /* (1000, 18, 2016/03/14) */
March 14, 2016
RE: [redacted]:
Dear [redacted]:
I am responding to your recent correspondence dated March 10, 2016, regarding [redacted].
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. We contacted Mr. [redacted] directly, and provided him with more details in regards to our ongoing research into his issue.
Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at [redacted] ext. [redacted].
Sincerely,
Jenna B.
Consumer Affairs Advocate

Revdex.com:
The company called me directly and advised they have adjusted the outstanding balance of $50.00 leaving my account with zero outstanding charges.  Thank you for your help Revdex.com!  - L [redacted]

I am rejecting this response because: as you can see United Healthcare continues to be obstructive, unhelpful, and avoids resolving the matter. United Healthcare refuses to tackle the issue and merely sends standard form letters that does not address the complaints we have raised.

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the...

enrollee.   Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ###-###-####, ext. [redacted].  Sincerely, Christine Q.Consumer Affairs Advocate

Hello, Thank you for bringing this concern to our attention. Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to the Revdex.com.  However, we will be responding directly to Mr. [redacted] to...

address their concerns.   Sincerely,  Optum Consumer Affairs

November 20, 2017  To Whom It May Concern: We are responding to this issue from [redacted] Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to the Revdex.com regarding these concerns. However, we will be...

responding directly to the [redacted] to address their concerns.   Sincerely,  Consumer AdvocateMike D.

November 16, 2016  To Whom It May Concern: We are responding to your recent correspondence dated November 8, 2016, regarding [redacted]. Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you...

regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.   Should you have any questions or comments, please feel free to email us at [email protected]. Sincerely, Katie [redacted]Consumer Advocate

June 1, 2016     To Whom It May Concern:   We are responding to your recent correspondence dated June 1, 2016, regarding Case ID # [redacted] for [redacted].   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond...

directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.    Should you have any questions or comments, please feel free to email us at [email protected].   Sincerely,     Consumer Advocate     NOTICE:  This communication may contain PERSONAL and CONFIDENTIAL information and is intended only for the use of the specific individual(s) to which it is addressed. It may contain Protected Health Information that is privileged and confidential.  Protected Health Information may be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this communication. If you are not an intended recipient, you are hereby notified that any unauthorized use, dissemination or copying of the information contained in it or attached to it is strictly prohibited. If you have received this in error, please securely destroy it and immediately notify the sender. Thank you.

(The consumer indicated he/she DID NOT accept the response from the business.)
I do not accept their response for two reasons:
1. They have NOT contacted me directly which they stated they would.
2. My best efforts to get this resolved without involving a third party have yielded NO results.
Note: Giving out private health information IS against HIPPA. However, explaining why a customer is BEING charged and how to remedy it (if incorrect) is general. They do NOT need to discuss my private medical history to disclose how to properly bill/charge/pay out for routine blood work.

I am rejecting this response because:  As of Yesterday, Nicole [redacted] of United Healthcare has not responded, nor do I expect that she will or will do anything to assist. I have spoken toNicole many times during the month of March and the beginning of April 2016. She stated she could do nothing to assist me, it was out of her hands, and the correct department to speak to wouldbe the exchange billing department. Which I have done, to no avail.  With regard to the HIPPA laws, my complaint has absolutely nothing to do with private health information, my complaintis solely due to a billing dispute. Nicole is also in receipt of my complete credit card transactions from January 2016 thru April 2016 which proved that I received two refunds (not three)for my premium payments. Once again, this is the source of the dispute. They (united healthcare) insist a third refund was given and I to date, have never received it.

March 15, 2018  To Whom It May Concern: We are responding to this issue from [redacted] Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to the Revdex.com regarding these concerns. However, we will be...

responding directly to the [redacted] to address their concerns.   Sincerely,  Consumer AdvocateMike D.

Initial Business Response /* (1000, 5, 2015/10/14) */
October 13, 2015
To Whom It May Concern:
We are responding to your recent correspondence dated October 13, 2015, regarding Mr. [redacted].
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA),...

we are unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee's correspondence and/or a description of the issue, we will be responding directly to the enrollee.
Should you have any questions or comments, please feel free to email us at [email protected].
Sincerely,
Suu [redacted]
Consumer Advocate

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the...

enrollee. Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ###-###-#### ext [redacted]. Sincerely, Kylie Consumer Affairs Advocate

.7-20-16 - resolved with member verbally on 7-19-16 - Y. Sleger UHC Consumer Affairs

July 6, 2016     To Whom It May Concern:   We are responding to your recent correspondence dated July 6, 2016, regarding [redacted].   Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you...

regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the enrollee.    Should you have any questions or comments, please feel free to email us at [email protected].   Sincerely,   Katie [redacted] Consumer Advocate

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding...

directly to the provider.    Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ###-###-####.     Sincerely,   Cindy H. Consumer Affairs Advocate

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollee’s correspondence and/or a description of the issue, we will be responding directly to the...

enrollee.  Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ###-###-####. Sincerely, Cindy H. Consumer Affairs Advocate