UnitedHealth Group

June 26, Revdex.com of Minnesota and North Dakota Attention: [redacted] Gannon Road Saint Paul MN 55116- Fax: (651) 695- Re: Revdex.com Complaint Case # [redacted] Member: [redacted] Plan Case Number: [redacted] Dear Whom it may concern, This response is in receipt of your inquiry dated: June 17, 2016, regarding your request for assistance from [redacted] Mr [redacted] has been identified as a member of our Medicare Prescription Drug Plan (PDP)This plan is regulated by the Centers for Medicare & Medicaid Services (CMS) Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you regarding Mr [redacted] ’s concerns Since your letter included a copy of the enrollee’s correspondence and/or a description of the complaint, we will be responding directly to the enrollee regarding their concerns United Healthcare has established an appeal and grievance resolution process in accordance with CMS regulations It is our position, and that of CMS, this process provides Medicare members with adequate recourse regarding any issues they may experience with their coverage, or any other services they received in connection with benefits provided by us We want to assure you this matter will be investigated and resolved within the CMS timeframes We have forwarded this complaint to our Appeal & Grievances Department so they can provide a written response to the complainant If you wish to find out additional information regarding how this complaint is resolved, you will need to contact Mr [redacted] directlyPlease note that grievances take up to calendar days and appeals can take up to calendar days Sincerely, Travis [redacted] Regulatory Complaints Department UnitedHealthcare Medicare & Retirement

Thank you for bringing this concern to our attentionDue 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

I am rejecting this response because: I not neither received a response, nor the ordered prescription material I would request you post the complaint

I am rejecting this response because: My issue is not with the premium guidelinesMy issue is that I was not communicated with by UHC that I was going to have a premium to pay, and the letter I received was dated after the effective dateIf you review your records, you can see that I attempted to disenroll from the program immediately upon receipt through the online disenrollment form (a method I chose because the representative I was speaking with disconnected me instead of transferring me to the disenrollment department) but I was told that even though the online message said I completed the form, it was unsuccessfulThe representative admitted that UHC had been having trouble with its website, so I would assume a system issue, not an error on my endI did not know this until I got a second bill for FebruaryThe two months of premiums UHC says I owe are, as far as I am concerned, fraudulent and nothing more than a way for a company to scam customers out of their moneyContacting CMS will not resolve this issue as it is a billing and communication issue on the part of UHC, not CMSI request that UHC takes the time to actually review my account and see that I have done everything in my power to disenroll from their program as quickly as possible, but due to a lack of communication and system errors on the part of UHC, I was not able to successfully do this until the effective date of February 28thThe January and February charges should be nullified, and my account balance should be set to zero dollars owed

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 Sincerely, [redacted] Per Email 3/25/@ 12:27PM CSTRevdex.com, Case # [redacted] ,I'm [redacted] , United Health care has worked to try to resolve this issueIt seems to me a worker sent a policy through too early in for the wrong amountI fee United Health Care, has tried to resolve this, even though it has taken a little while and there was a lot of confusionThe money has been refunded, Bofa returned fees, and United Health care, has just returned premiumI will keep the new policy, they will receive a check for $138, in the mail for first months paymentApril I received the policy for the new insurance three days ago, I will keep itYou can close the Revdex.com case against United HealthThey did NOT provide me with a direct email to contact themYou can close the case against Health CareThank you, [redacted] 3/25/

It was identified that the case had been termed due to non-payment effective 02/28/17, however it has since been reinstated with no gap in coverage effective 09/01/13—current There is a current balance on the account of $through May and this is showing correctly in our system The balance will need to be paid by 04/30/to remain current A customer service representative spoke to the mother to advise that the amount needed to be paid by 04/30/

To whom it may concern: Direct contact will be made with the complainant to provide resolutionThank you, 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 concernsSince 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 meI can be reached during business hours at ###-###-#### Sincerely, Nichole Consumer Affairs Advocate

5-16-- Issue being extended by one week - 5-23-- Just spoke with member's mother and she understands the situation I will be sending issue back to Billing/Eligibility with part of issue still not resolved per the member's mother Will be closing with member's mother verbally when completed Y [redacted] UHC Consumer Affairs

I am rejecting this response because: Unlike what they are saying my response had nothing to do with privacy issues and they not respond directly to me as they told you that they were

December 15, To Whom It May Concern: We are responding to this issue from Mr [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 concernsHowever, we will be responding directly to Mr [redacted] to address their concerns Sincerely, Optum Consumer Affairs

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] Unfortunately, due to HIPPA requirements, it did not state exactly what United Health Group's response was in this e-mailHowever, I received a phone call this morning from United Health Group Representative, Tiffany ***She told me over the phone that they had overturned their prior decision and have decided to reimburse us for the $we paid out that should have been covered by our insurance for the facility charge at the surgery centerShe said I should be receiving a check in the mail in approximately one week.If this is true and I receive a check for $from United Healthcare I will be very pleased and accept this business's response to resolve this complaint

To Whom It May Concern: We are in receipt of your inquiry dated; March 13, regarding your request for assistance from [redacted] has been identified as a member of our Medicare Prescription Drug Plan (PDP) This plan is regulated by the Centers for Medicare & Medicaid Services (CMS) Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you regarding [redacted] ***’ concerns Since your letter included a copy of the enrollee’s correspondence and/or a description of the complaint, we will be responding directly to the enrollee regarding their concerns United Healthcare has established an appeal and grievance resolution process in accordance with CMS regulations It is our position, and that of CMS, this process provides Medicare members with adequate recourse regarding any issues they may experience with their coverage, or any other services they received in connection with benefits provided by us We want to assure you this matter will be investigated and resolved within the CMS timeframes We have forwarded this complaint to our Appeal & Grievances Department so they can provide a written response to the complainant If you wish to find out additional information regarding how this complaint is resolved, you will need to contact Mr [redacted] directlyPlease note that grievances take up to calendar days and appeals can take up to calendar days Sincerely, LaShon [redacted] Regulatory Complaints Department UnitedHealthcare Medicare & Retirement

November 14, To Whom It May Concern: We are responding to your recent correspondence, 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 concernsSince 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 addressedIt 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 communicationIf 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 prohibitedIf you have received this in error, please securely destroy it and immediately notify the senderThank you

Hello, Thank you for bringing this concern to our attentionDue 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 [redacted] to address their concernsThank you Optum Consumer Affairs

I am rejecting this response because:I received a call from a Josh [redacted] at United Health Group on 2/21/at 3:p.m He indicated they might be able to allow me a transition period especially with my physical therapy and I would get a letter within 5-days The letter came today from UMR and they are denying transition of care.I am at the end of my life and just don't need this hassle How will I find an internist who will work with me? It took trys to find DrWatsonEx - I don't want any tests for "cancer" as I would not survive treatment How will I get another orthopedic group where I can get physical therapy for my neck without having to get a referralDitto for Cardiologist.Although my insurance doesn't require a referral, most doctors in Greenville Health System do

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concernsSince 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 meI can be reached during business hours at ###-###-####.Sincerely,Nichole L.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 concernsSince 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 meI can be reached during business hours at ###-###-####Sincerely, Kylie DConsumer Affairs Advocate

Initial Business Response / [redacted] (1000, 5, 2015/10/14) */ October 13, 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 concernsSince 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

Contacted United Healthcare on 3/21/and was told by a supervisor to get an Eligibility Letter from [redacted] , which I already did in 8/Called [redacted] , but the agent there was concerned that an Eligibility Letter does not have a policy end date, so sent the Eligibility Letter along with an additional letter showing the end dates to the fax number provided to me by United along with a confirmation to be mailed to me While speaking with the supervisor at United Healthcare, she revealed to me that United contacted [redacted] on 3/16/to confirm that my daughter did have coverage with [redacted] on the start date of my United policy (7/6/15) and used that information to deny claims on 8/6/and 8/17/United also called my husband on 3/16/to ask him if my daughter and I have [redacted] insurance and he said no I would like United to tell me why a United employee contacted [redacted] to research their responsibility for claims made on 8/6/and 8/17/but never actually asked [redacted] if we were insured through them on these datesI am concerned that these actions are a systematic issue that may be designed to delay payment on legitimate claims and would like to receive comment from United