Rachelle Nuckols sent a message to Stephen Hemsley Chief Executive Officer of UnitedHealth Group Inc. email address that said:
Good afternoon,
Peggy Hale member # 391522501 is a 92year old female that has been seeing Orthopaedic since 2016 for hip problems. This patient was under the WEL MED managed care program. On 10/13/2017 a verification call was made to UHC regarding Peggy hales benefits. Never once was we informed MS. Hales managed care group changed to Silverback. On 11/7/2017, Ms Hale made an appointment and informed she received a new card and is now managed by NTSP. Upon calling to verify we were informed that MS Hale managed care plan retro back to 9/1/2017. With all this being said, this now leaves patient owing for the visit on 10/18/2017 , due to miscommunication from the verifier and from UHC ONLINE. I have called the members service department, spoke with Chris, supervisor NOR, and Christine in member services. Chrisitine, in member services stated, according to her records the system Droped Pierre Semrani and assigned a new pcp without patient knowledge and was for only a month . Patient was unaware and did come in for her appointment on 10/18/2017, without a referral, one because she wasnt aware and secondly because we were given wrong information.. Now the patient will be responsible for a bill that is not her fault, nor is it our fault because benefits were verified. I know things happen, but this is a total case of poor customer service and horrible patient care. Again, this is a 92 year old waiting to be seen with hip problems. In speaking to Nor she pulled records of the calls and even the records were incorrect. Nor was stating for Dr. BEN, someone from Dr. Grantham office called and was verifying benefits, as I explained to NOR we dont have a Dr. Ben nor is there a Ben in this office. Needless to say this is a big mess. All we are asking is that this patient has a retro auth to cover her for the 10/18/2017 visit to Dr. Cori Grantham. Thank you for taking the time to address this issue for Ms. Hale.
Rachelle Nuckols
Insurance Specialist
Integrated Medical Management
469-209-8099