Katherine's complaint:
July 04, 2013

Insurance Company: UnitedHealth Group
Coverage Type: Health Insurance

• PolicyHolder Service - Delays/No Response
• Claim Handling - Delays upon Delays
• Claim Handling - Unsatisfactory Settlement/Offer
• Claim Handling - Denial of Claim

My husband retired from Lozier last June, 2012. Prior to retiring he was covered by BCBS (primary) and APWU (secondary) under my employer. He went to Clocktower Chiropractic Inc at Westroads on several dates between 6/21 to 8/1/12. BCBS paid as primary for the dates before 7/1/12. There was some confusion as to who was primary effective 7/1/12 Medicare or APWU. Finally in October, 2012 it was explained that APWU should be primary since my employer has over 50 employees. In the meantime Medicare paid the claims from 7/1 to 8/1/12 as primary. I submitted copies (faxed and mailed) of the Explanation of Benefits from BCBS and Medicare multiple times and they keep denying these claims because their records indicate he has primary medical insurance with another company (other than Medicare). I have called at least four times and each time I get transferred to their Adjustment Department who promise to finalize the claim within 10 days. The next statement shows the same thing - denied due to other insurance. I need someone to help get this resolved asap as it has been over one year without payment.

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