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United Health Group complaints

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2300 Main Street
Irvine, CA 92614 | Get Directions

(800) 842-2656

http://www.unitedhealthgroup.c...

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Total Amount in Dispute:
$1,026.00

Total Amount Settled:
$0.00

Complaint Experience

54%

Complaint Resolution Index (CRI)

Complaint Resolution Index (CRI) Explained The Complaint Resolution Index (CRI) is an indicator on how responsive a company is in addressing and resolving customer complaints brought to their attention by BCA. If they are considering doing business with the company, consumers can use this indicator to forecast the likelihood of having their issues addressed if a problem arises. CRI measures the company's customer satisfaction abilities through BCA’s complaint mediation process.

A variety of factors are considered when calculating CRI. This includes how quickly a company responds to complaints, the number of complaints against a company, whether the company addressed complaint allegations, and the outcome of the complaints. CRI is just a subset of the overall rating for the company. Consumers are encouraged to take into consideration the company's CRI, their overall BCA letter rating and other relevant information about the company so they can make a well-informed purchasing decision.

BCA's Summary and Analysis:

Our complaint history for this company shows that the company responded to and gave proper consideration to most complaints. However, one or more complaints are unresolved meaning the company failed to properly address the complaint allegations or their response was inadequate.

Complaint Closing Statistics

24 complaints against United Health Group closed in last 3 years.

Complaints	Type of response
0	Making a full refund, as the consumer requested
0	Making a partial refund
7	Agreed to make an adjustment
5	Refusing to make an adjustment
8	Refuse to adjust, relying on terms of agreement
4	Unanswered

24 complaints against United Health Group

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5/19/2024

RESPONSE: Refusing to make an adjustment Amount in Dispute: $0.00 Amount Settled: $0.00

Customer Complaint

5/1/2024

They won't cover therapy that I need because I'm in a nursing home. I've had therapy for 5 months in a nursing home, My therapist has changed jobs and is doing telethealth services now and is very willing to continue with me and Psychological Healthcare was very willing to accept me. United Healthcare refused because I'm in Elderwood nursing home. They paid while I was in the nursing home but won't do it now. I' have Stage 4 Glioblstoma for a year and I really need therapy. There's no good reason for the refusal. Resolution Sought I want to continue having therapy with the same therapist I had for 5 months.

Company Response

5/3/2024

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), we are unable to respond directly to you regarding these concerns. Since you provided a copy of the complainant’s description of the complaint, we have responded directly to the complainant.

3/21/2024

RESPONSE: Refuse to adjust, relying on terms of agreement Amount in Dispute: $0.00 Amount Settled: $0.00

Customer Complaint

2/27/2024

Claims not processed correctly. Suggested to commit child abuse and neglect to my special needs daughter, have paperwork. Not being able to get claims settled. Being hung up on by representatives. Won't have managers or supervisors call when requested, providers can not reach them to get authorizations. Resolution Sought Give me the proper and correct healthcare information . Answer the phone. Let me know what correctly is going on with my claim. Do not suggest I commit fraud or child abuse and neglect to my child rather than pay for a medical bed prescribed by dr.

Company Response

3/7/2024

Customer Rebuttal

3/11/2024

Claims are being processed slowly. Services are not being paid on time. UMR has lied repeatedly that I have used all my appeals, when UMR was not able to be contacted by provider to a peer to peer. Bed was denied due to rationale "NOT CURING AUTISM" in the meantime child has loose teeth due to smashing head on floors and walls, has gotten caught in sheets while medicated, fallen off couch and has sustained other injury not requiring hospitalization due to parent staying awake to make sure child is safe while sleeping, doesn't roam the house, putting things in her mouth. Case Manager from UMR closed case due to "not being able to help" . Received letter that I closed case with complex care nurse because everything is better and I do not need their services, which is untrue. I The mother, have been hospitalized due to the toll this company has put on me, not allowing me to be healthy to take care of my sick child.

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