Thursday, June 16, 2011

UHC/Medco Update: Resolution

On Monday afternoon, I spoke with Lynne H, UHC's Director of Media Relations. As noted last week, I had already discussed the issue with the Communications VP at United Health Group, and the UHC Account Coordinator at Medco. There have been two basic concerns here:

First, the original mis-pricing which cost my co-worker over $100, and

Second, ascertaining the extent of the problem (how many other insureds have been affected?).

Yesterday (the 15th), my co-worker spoke again with the Medco Account Coordinator, who assured her that there is no dispute on their part that this occurred (thanks to the screenshots we kept), but that he had never seen this particular problem before (more on that in a moment).


He went on to confirm that, now that they're aware of the problem, they're looking to correct it going forward, and that they would issue a credit to her charge card for this transaction (which we have confirmed has taken place). He also confirmed something we already knew: that the system does, in fact, know the status of her account (deductible credit, claims paid, plan design, etc), and that it takes these factors into account.

The underlying problem seems to be that the med that showed up with the $33 pricing was, in fact, not available through the Medco mail-order program, and that an alternative (more expensive, natch!) was substituted. According to "the Medco guy," this was an honest mistake, not an attempt to defraud my co-worker.

I'll accept that - we have numerous enough examples of Stupid Carrier Tricks to support such a contention.

Finally, he and his staff will be reviewing their customer service processes; the fact that this took almost 2 weeks, numerous emails and phone calls, and two blog posts to be resolved does not reflect well on their current practices. It didn't help that my co-worker was told to wait 3 days and then call them; this is also not acceptable, and they're working on that, as well.

Here's the thing: I do appreciate the quick response once the powers-that-be at UHC and Medco read the original post. It's humbling for me to know that IB is able to help folks amplify their voices, and that what we say has some authority. On the other hand, just because the Medco guy has never seen this before doesn't mean that it hasn't happened (or doesn't continue to happen). How many folks have run into this and just thrown up their hands in resignation that they've been "screwed by the insurance company again?"

Hopefully, this is a small number of insureds, and the problem will now be a thing of the past.

Thanks to UHC's Tyler M and Lynne H, and Medco's Steven W for their help in resolving this.
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