I have pathology reports from Hospital A that I received under a charity care arrangement. They are for dermatology. The reports revealed skin cancer and I needed surgery, but the hospital fused to allow me to use their charity care for the surgery I might be taking a low wage job to try and get private employer group PPO health benefits. But the plan would be with UHC. If I already have the biopsy reports showing biopsy #1, biopsy #2, biopsy #3, biopsy #4 are basal cells and they require Mohs surgery, do I still have to wait months to set up an appointment with a dermatologist and then WAIT for a referral to see a Mohs specialist? Forget about the prior dermatologist who did the biopsies. He works for a large healthcare system that won't allow him to refer me outside of their network. If I literally have the pathology biopsies, can't a potential UHC in-network Mohs surgeon's office use that? Or does UHC ppo private group plan insurance and the participating Mohs doctor under UHC insurance require another dermatology referral, which would mean I'd have to wait many months just for that and delay the surgery I desperately need.

My Dr wants to enroll me in a weight loss support group program. I have a high deductible plan with UHC so I will essentially be paying out of pocket until I meet my annual deductible. Dr's office asked me to call my insurance to check if it's covered, and they told me the billing codes. UHC said it's covered, but the cost ranges from $30-250 (per 20 minute session) depending on what the provider charges. They will pay 90% after I meet my deductible. They say that they don't know how much a particular provider will charge. I asked my Dr what they would charge, and they said the price is set by the insurance company. Who is lying?

I have a high deductible UnitedHealthcare plan through work and my primary care doc referred me to a local radiology clinic for a mammogram and ultrasound for a lump in my armpit (everything turned out okay). I got the bill the other day and almost choked, $635! I called UH and they said since it was billed as diagnostic and they don't offer any discounts, they only paid about $50 and I paid the rest, essentially it barely mattered that I had insurance. I am 35 so they aren't covered yet as preventative. Should I appeal this? It's so much money after being laid off for 7 months before.

I have been dealing with new health issues and it’s freaking me out. I was previously on medicaid under my mother but became ineligible after I turned 19. I cannot enroll for myself because I was denied twice already for other reasons/don’t meet this “qualification.” Before that happened, I was with a provider who ordered a scan for me that showed something but I had to cancel the appointment after losing coverage. My mother then unfortunately put me under a plan under UHC but after I started having issues with them (plus all the things that’s been said about them in general), I’m thinking I should look for another. I’m not sure where to go from here though because it’s passed the enrollment deadline since a while ago and I do not meet any of the special circumstances to enroll. Both of my parents are on medicaid so that’s not an option for me anymore. (for context I am 20F in college, currently don’t work a job, and from Illinois)

I'm a 24 year old male in NE with UnitedHealthcare. I make approximately $82k gross. I've had UHC for a few years now and have always done my yearly preventive checkup, which was always 100% covered until now. I've contacted both my provider and UHC trying to figure out why I'm suddenly being billed. When I check my claims, the labs given were mostly covered by my plan, with small amounts for each service charged to me. * Labs: * 80061 LIPID PANE, * 84439 ASSAY OF FREE THYROXINE, * 80050 GENERAL HEALTH PANEL, * 81001 URINALYSIS AUTO W/SCOPE, * 36415 COLL VENOUS BLD VENIPUNCTURE * If I have to pay my deductible before labs being covered, why are they covering ~77% of my cost anyways? If they're 100% covered, why do I have any deductible? * My insurance says it was coded incorrectly, but my provider says it was correct. * I asked my insurance to compare my previous years' coding to my current claim, and they said it was the exact same thing. CPT and Z codes. * I was given a follow-up call and sent [this pdf](https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/preventive-care-services.pdf) which details which codes are considered preventive, and I think I see my labs aren't? But I don't really understand what it all means, and either way it's the same coding as previous years, so why were they covered before but not now? Why cover them partially? * If the guidelines have changed, am I responsible for tracking that and telling my doctor what to do at my yearly checkups? * Is there a super simple explanation for why I'm being charged? Does the insurance have a max payout which the provider over-charged, leaving me to pay the rest? How can I tell? Thanks, this is all very confusing and frustrating to deal with. I don't know much about insurance or anything, but I feel like this is wrong somehow.

I have read some prior threads for this but they are from a year ago and I'm curious if there have been any changes. Background: I have had UHC and used Optum for my specialty pharmacy for years. My specialty medication is a biologic with no generic equivalent. The manufacturer provides me with both a copay card and a payment card. My deductible has consistently been met in January every year using the payment card, and then the copay card picks up the copay for each month for the rest of the year. Situation: This year, the manufacturer payment card was processed as usual and applied towards my deductible, however, they went back a few weeks later and reversed it from my deductible. When I called them, they said nothing has changed and the payment card, as a form of manufacturer assistance, cannot be applied towards my deductible, despite that having always been the case. Based on what I have read about an HHS ruling, they are required to apply this towards my deductible as there is not a generic available. I filed an appeal and was denied. My employer plan is likely self funded, but from what I have read, that should not matter. Has anyone gotten a resolution to this issue?

I have UHC and while taking care of some things on the phone with a representative I asked a question out of curiosity which was just my confusion that sometimes when I get my botox for migraines my provider has me pay nothing and I get the bill later, other times I just have to make "a" payment and then get the bill later. When I say get the bill later in both cases I mean after the claim has gone through insurance I then get the billed amount I owe, and the portal for UHC updates with my EOB (I use the EOB to apply for a savings program to be reimbursed by a third party). My most recent appointment however they made me pay the full amount of botox up front otherwise they refused to treat me. I am disabled without this treatment so I just found a card with enough money on it and gave it to them. The insurance representative told me they aren't to make me pay more than a voluntary small amount of my choice if I want to, and that they aren't supposed to deny me my treatment that they approved. She told me to not pay next time and if they push back to call United and get a representative on the phone. My mother used to work medical scheduling however and she insists they can make me pay whatever amount they want and reimburse me later. I am thinking my mom might be more right but just want to hear it straight. For the record I am in the (slow) process of changing migraine treatment providers for a number of reasons related to poor communication or miscommunication.

Long story short, I recently got a grant for my son who has autism spectrum disorder and was able to find a provider who had social skills therapy for him. The grant will reimburse me costs 100% however they need a copy of the EOB. I found a provider who was out of network but was the only one offering this therapy in the time period I needed it. She was upfront saying that we would have to file our own claim which I have no problem with. She provided the superbill and all of the codes. Well today I logged into UHC to try to submit a mental health claim and the form is not available, then I called them and they told me that I cannot submit my own claim. I told them that my provider does not file claims but they were insistent on saying that the doctor would have to file them. Is this a common practice? I am just frustrated.

So like the title says I had 2 doctor visit back to back days. One I saw the PA and the other I saw the NP. But the medical claim with my insurance says I saw the doctor. I received a bill from the clinic stating I owe an additional $76.93 for the PA and nothing additional for the NP. Both doctors are from same clinic but different specialties. I reached out to my insurance and they said it was both bill coded as me seeing the doctors. Is this correct? I reached out to the billing department of the clinic and it’s been almost 2 weeks and they haven’t gotten back to me yet. Is this correct? I paid $220.63 both times (I have a high deductible plan) I think. I don’t have a copay - I pay for everything my insurance doesn’t cover(which they don’t cover very much) If you have more questions to help answer this let me know. In the last month I’ve spent $1600 in medical and I want to make sure I’m being billed a surplus amount. Edit- I’m 29F from Texas and I’m insured through my job with UHC

I got an advertisement from my insurance, UHC sent to my email about a program called Real Appeal. The title said “Reach your weight loss goals now, at no additional cost” so I signed up and made an account. It looks like UHC denied the claim and I now owe $162.23. I set up a Teledoc appointment but missed it before looking at my claims (my mistake I know). I missed the appointment and haven’t rescheduled. I’d link the email given but not sure how.