I received a bill the other day for $1,400 for a procedure performed on me in February. It was so long ago that I didn’t even remember having a procedure done in February or why. I went through my Insurance submission statements to refresh my memory. I couldn’t find anything that quite matched either the date the provider gave or the price they charged.

So I called United Healthcare’s (UHC) customer service. The agent also was unable to explain what was going on so she put me on hold as she needed to talk to a supervisor. One half hour later, she has an explanation. The provider didn’t submit their bill in a timely manner so UHC declined payment.

This was, in no way, a satisfactory explanation because the company was now billing me instead of the insurance company. She then helpfully suggested calling the provider and asking for them to resubmit. This made no sense to me. First, UHC declined payment because the provider had exceeded their deadline for submissions. Does resubmitting the bill put it through some time machine which then makes the bill be on time? Furthermore, why does the provider now think I am responsible for the bill? I didn’t submit the late bill and I didn’t decline payment of the bill. This, as far as I could see, had nothing to do with me at all. It was between UHC and the company billing them.

The agent was speechless for a few seconds as she didn’t have a canned reply for my question. These questions stunned her into silence. Finally, she managed to repeat her previous statement about asking the provider to resubmit. I explained to her that she could call the provider and tell them to resubmit herself as this had nothing to do with me. She was so silent that I had to interrupt her silence with a question, so if UHC declines payment again then UHC will tell the provider to stop billing me because they screwed up. More silence.

I tried a different approach. “So, I shouldn’t pay this bill because all the provider has to do is resubmit the bill and they will get paid.” More silence. Finally, the poor thing lamely offered that I should call the provider and ask them to resubmit their bill. I asked again, “And then they will get paid, right?” Silence. I asked, “what if UHC denies the payment again and the provider bills me again what should I do.” Again silence.

I asked to speak to a supervisor but before I was disconnected from her I asked her to make a note in my file that I am not paying this bill until I get an explanation. I did this because I rarely, if ever, get connected to a supervisor. I didn’t. Odd that because she had just spoken with one regarding my claim but then I image UHC supervisors are bombarded with agents asking questions. I was forced to leave a message. My experience with leaving a message with my insurance companies or any medical provider regarding a billing question is that I will never receive a call back and I haven’t. It now has been over 48 hours which is the time frame UHC gives for these return calls.

So to sum it up:

1.UHC declined to pay for my procedure because the provider failed to bill them in a timely fashion.

2. Because the provider didn’t get paid in a timely manner, they are now billing me.

3. UHC won’t do anything to help me. They expect me to contact the provider in order to resubmit their claim and won’t guarantee that this resubmission will result in payment.

4. Which is kind of shitty behavior because the provider did supply the service and they do have a contract with UHC. But OK, I get it, there has to be some deadlines for bill submission.

5. It is equally shitty that UHC expects me to do their legwork when I have nothing to do with the problem. They declined payment based upon guidelines that I assume their providers are aware of. It then becomes their responsibility to inform the provider to stop billing me as they didn’t follow UHC requirements for billing.

This took about 45 minutes of my time to have, at the end of this call, absolutely no resolution to my problem. I am certain that I have another long phone call with someone in the future. This is horrible customer service and very suspicious too. Why are they asking the provider to resubmit? If there are rules regarding submission, there are rules. If the provider didn’t follow these rules, then the provider doesn’t receive payment. It sounds like they are trying to get the provider to back down or for me to pay the bill. Does this mean if they get harassed enough by the provider and the customer that they will grudgingly pay.?

What did Luigi Mangione’s put on his bullets: Delay, deny and depose.