UMR Health Insurance Consumer Reviews - Page 2

MISSISSIPPI -- They create as many loopholes as possible. You can have an emergency room visit, just don't cover the doctor. They will not pay. These guys are crooks!!! You're better off having no insurance. At least you can get a cash discount.

LAKE CITY, FL -- Hold time is ridiculous and to be transferred back and forth and get hung up on. My time is valuable and I absolutely hate when I see a UMR CLIENT enter our facility. WORST INSURANCE TO DEAL WITH!!!!

My mom has dental insurance with UMR. They refuse to pay anything because I am her son (this is what they told my front desk staff). I have never been in network with UMR (thank goodness). They used to pay dental claims, but suddenly stopped a couple years ago, claiming that she needs to go to an in-network dentist. These folks are only in business to take premiums from unsuspecting consumers, then find ways to deny/delay paying. Avoid using this company for dental insurance at all costs.

SAN DIEGO -- Twice now basic services have not been paid to service providers. It took almost a year to pay for my cataract surgery which was pre-approved and now a recent crown replacement with my dentist has been 6 months! They keep asking for same ** documents to drag out payment. They should be investigated and fined. Horrible insurance company!!!

LAKE MARY, FLORIDA -- My company just changed from Cigna to United healthcare, but the handling of my plan is done through UMR. In the last three days I have had to call four times to find information and have spoken to four different people. The three first two girls I spoke to on the first day seemed to have poor English and were not very helpful at all.

I was looking for RX advice and the first girl abruptly told me that I had to call my Rx plan. I searched for that number and seemed to have no note of this. I called back and asked for the number. I was told, patronisingly, that it was at the top right hand corner of my card. I advised that it wasn't, and could I have the number. Instead she passed me through. An hour later I had some more information to discuss with the pharmacy benefits tam and had to go the whole thing again. This time I got Dominic. He was GREAT and not only gave me the number but found it in miniscule numbers on the back of my card, right at the bottom, with no clear indication of what the number was for.

Today I had to call again to ask for help finding a provider. Not only did they refuse to email me the names of the providers, the girl made it pretty clear she did not have the time to be going through names to help me, she checked if I had computer access and practically insisted I use the website..which is not the greatest thing either. My company changed from Cigna to United Healthcare at the turn of the year. I am paying a lot more for my healthcare this year and this third party bunch of jokers do not come close to providing the service at the Cigna call center. Apart from

GUNNISON, COLORADO -- UMR purchased my previous health insurance company, CNIC. CNIC paid my bills on time. UMR does not pay my bills on time. Every month I have an infusion and every month UMR requests my hospital to send all my records to them. The hospital has sent my complete records to UMR more than once. UMR claims that my infusions are not pre-authorized but the hospital is certain that the infusions have been pre-authorized.

The hospital would not have ordered the infusion products without pre-authorization because they are very expensive. Another reason UMR gives for not paying is that they say the hospital has coded the procedure incorrectly as "experimental/investigative". Coding with UMR is a nightmare. I have checked with the hospital and they say their coding is correct. I have a health insurance advocate through my job and he has not been able to get UMR to pay the bills or get to the bottom of the problem. I am in the process of getting UMR's mistakes about my infusions resolved.

Here's another example of UMR's incompetency. I saw my optometrist in May and he prescribed a medication. It took three weeks for UMR to reject the medication. When I did some investigating about the rejection through my health insurance advocate, I found out that UMR had sent the request for a letter of necessity to the wrong doctor in the wrong city. I had to take time out of my life to get the correct information to UMR and they approved the medication for 6 months.

I feel that I am doing UMR's work for them but am not getting paid for my time and skills. If you or your company can choose a different health insurance company, I urge you to avoid UMR. UMR will cost you more time and aggravation than they are worth.

I had a detached retina then had to have cataract surgery. My policy says glasses are "covered" after eye surgery. I called UMR about purchasing glasses at Walmart. I was told to purchase the glasses then send in the receipt and I would get payment. After purchasing the glasses, I sent in everything. I received a billing from UMR saying the glasses were not covered because it was from a "routine eye exam".

I called and explained the situation to two different people and was told that a mistake had been made on their part and that they would reimburse me for the glasses (talked to Gina I believe). No money. Called again and talked to Josh. After 25 minutes on the phone, he too reassured me that the glasses were covered and that I would be receiving reimbursement. He said he would use his lunchtime to complete this and would call me when it was settled. Great guy - actually went out of his way to help. He left a message on my phone that afternoon that he had it all taken care of and that I would be receiving reimbursement. No money.

Yesterday talked to Sue in Claims. She now says the cost of glasses was applied to my deductible. Her words, "When the policy says it is covered, it means that it is applied to your deductible". What?? I talked to three people before this and never was that mentioned. Then I noticed I had reached my deductible and pointed this out to her. She then told me that Walmart is not in the network of providers so I could not get reimbursed. When I told her that I called to check on this early in the game, she ignored my request to review earlier notes on my account.

When I asked to speak to someone else, Sue told me she sat next to the person who determined the claim and that she already checked with him and she has it right. To add more to the frustration, I asked Sue to direct me to a survey I had agreed to take at the beginning of the call, she said she would connect me then promptly hung up. I was never disrespectful or rude during this entire conversation. The prompt also says that calls can be recorded. I would like them to use those calls as proof of the poor service I am receiving!

BETTENDORF, IOWA -- I called the company before I scheduled my surgery, that my DR. said that I needed and they said I was approved, so we scheduled it. Then, the "nurse" that works for them denied my claim and said that I could do other things before this. I am sorry, but if the DR. said that you had precancerous cells in your body you would want them out. How can an insurance company deny someone a surgery that is to get cancer out of the body? Then, when I called her to ask questions, she never wanted to call me back. Very disappointed and will be looking for a new insurance company that cares about the customers.

SPRINGFIELD, MISSOURI -- We have had issues getting things paid for, for years now. The only way we ever get them to actually pay is when we threaten to sue them and take them to court, then they magically respond and do something. They also never address their own problems, even if you ask specifically why they handled one situation differently to another situation that was exactly the same.

Only one person was ever friendly and tried to get my problem resolved, and she did. And I was going through the exact same situation recently and have talked to multiple representatives and they won't even acknowledge or answer when I ask why they can't submit a claim again, which is what the lady who had helped me before had to do, which took care of the problem. The representatives just ignored everything I said and would not help me. Terrible, terrible customer service.

SALT LAKE CITY, UTAH -- All I have to say is that unfortunately I have to deal with these reps all day long since I work with insurances at a dental office. The reps have a terrible attitude! They do NOT like to help you and it all seems like a task for them. Once I spoke with a "Kristen" who denied me to speak with a supervisor and wouldn't even give me contact info. It's so common with this group of people. I wrote a complaint on their website some time back but I have not seen improvement. I hope someone who can make a change sees these reviews.