UMR insurance is. It is the largest third-party administrator (TPA) in the USA. Universal Medical Resources has a national scope and at the same time still offering regional attention to customers.
Based on the company’s official website, UMR Insurance processing more than forty million claims a year in serving more than 1,260 customers and three million plan members and work with more than 150 insurance networks.
But what about real life? This story told me my neighbor. What do you think about?
UMR is a subsidiary of United Healthcare and is contracted with my spouse’s employer to administer the companies healthcare plan. Last year we had constant problems with their processing our claims incorrectly. I had to make my own spreadsheet and track all of our bills and payments to ensure we were covered properly, and I spent hours contacting UMR to straighten out their mistakes.
Then this year, in addition to a medical provider still owing me over 600 dollar I have yet to get back and it was due to a mistake on the part of UMR, at the very end of the year, for the 1st time, UMR refused to pay for my mammogram and covered pap-smear. I had them at the same time of year I normally due to ensure there is a full year between them, and I’d met my 2500 dollar deductible several months before. Yet, they refused and claimed a new rule to our coverage that I am still covered 100% for a pap, mammogram, and well adult exam and labs regardless of whether I’ve met my deductible, but the
well-adult benefit is covered only up to 500 dollar and I’d already used it for the year. For the first time they stuck the pap and mammogram into the well-adult exam category and said I had to pay because I’d used my 500 dollar allotment for the year. One exam with accompanying blood lab work, a pap, and a mammogram cannot even begin to be covered by only 500 dollar, especially in Alaska where medical care costs 30-55% more than other places in the country. What a scam!
In addition, blood work I had done that week, not even related to the pap and exam, they refused to cover for the same reason, but my coverage contract states that I have 100% coverage for everything after I meet my 2500 dollar deductible.
UMR/UHC ended up costing us an extra 3000 dollar out of pocket at the end of the year and didn’t even bother to respond to my appeals! I did get one email after I appealed a second time and forwarded the information to my husband’s HR office, and in the email they asked me to be patient for a couple of days while they examined my file, and then I never heard from them again. That was last summer and it is now March.
- Customer Support. They answer calls and communicate nice way.
- Payment Interaction. Unfortunately, they will not pay to you even 10% from what you expect.
- I recommend. I don’t recommend, because, right insurance company means good payments.