As I last left you, I was still dealing with a large amount of unpaid monies for United Healthcare due to UCI's negligence.I began reading through the informative UC Irvine student health plan pamphlet (which I had never received, and had to locate online). I was trying to discover if there was any way out of this horrific debt into which I had traipsed.
Imagine my surprise (and relief) when I found the caveat I so desperately craved. Buried in the handbook was a list of situations as to when you would NOT need a referral in order to visit a doctor outside of the Student Health Center (discussed in the previous post). Luckily for me, I fell under situation #3: No referral is necessary "when service is rendered at another facility during break or vacation periods."
As a chemistry grad student, I do not personally have breaks or vacation periods. Fortuitously, I had gone to the doctor on December 30, 2009, smack dab in the middle of UC Irvine's winter break.
Feeling quite smug, I called up United Healthcare with my new found information. They took note, said they would send my claims to a review panel, and get back to me.
...
They did not get back to me, so two weeks later I called them back and asked about it. They said that my petition had been denied because the Student Health Center was open on that day. I informed them that this tidbit of information was irrelevant, as caveat #3 said nothing about whether or not the SHC had to be open and merely that UC Irvine had to be on holiday. The following is how most of our conversation went:
Customer Service: "Your petition was denied because the SHC was open on that day."
Me: "That is irrelevant, because UC Irvine was on winter break. ::reading the brochure word for word::"
CS: "Yes, but the SHC was open."
Me: "I understand that, but that doesn't matter according to this point. ::more reading::"
CS: "Yes, but the SHC was open on that day."
etc.
I asked them to resubmit the petition, with the proper wording. They said that I could not submit a second petition as the first one was denied, and that I would have to pay the bills. After paying the bills, I would be allowed to submit a written petition.
Me: "Let me get this straight, I have to pay bills for which I am not responsible, and then waste my time writing a new petition because the review committee is unable to read the health plan brochure which they wrote."
CS: "Yes, you can submit a second petition."
HELL NO. I was not about to pay bills for which I had been tricked into having in the first place.
So I did what anyone should do when faced with low level, non-brain-functioning customer service flunkies. I asked to speak to the management.
Surprisingly, this turned out to be super effective (though I did have to have a lengthy argument with said flunky before they would pass off the phone). The manager lady achieved understanding on a level that surpassed all of my expectations. She dealt with the matter, and United Healthcare actually paid their share!! Fact: this was amazing.
However, this is not the end of my story...
