United Health Care services provides an explaination of benifits on line to it's policy holders. I printed one of these out prior to going to a physician for my annual exam. The EOB reads: Physician's Office Services Both In/Out of Network under which fall a description reading "Roputine physical examinations" then the EOB is broken down into In Network and Out of Network. If you were to read this sheet you would read it as I did. The first section covers In & Out of Network Services and the other sections cover In Network, then Out of Network. 3 sections, right? Well they are claiming that these 3 sections are in fact meant to be read as only 2 sections. I don't care what they say anyone with half a brain would read it as I did, as it is clearly labeled and outlined. Bottom line is that they are refusing to pay the fees for my annual examination. Have you ever in your life had health insurance that did not cover your annual exam? Of course not, that is rediculous. Not only that but when I called, on March 7th to see why my claim had been denied they said someone had made a typo and that they would promptly pay the bill. They said I was to check their web site in 2-3 weeks to verify that it had been paid. You guessed it, it was denied again and again. This EOB that I have right in front of me is VERY misleading. I am not the only one that has read this EOB as I have explained. I tested it on a co-worker and she read it the same as I did. That a routine physical exam is covered by both in and out of network services. I am furious. I'm a working class woman and I would have never in a million years gone to see a physician if I though that my insurance would not cover it. I don't know about you but I can not afford to just throw my money away. Even more infuriating is the fact that they told they made a mistake and that they would take care of it and I had to find out from the collection dept at my physicians office that I need to make a payment ASAP.
Bonita Springs, Florida