ComplaintsforUnited Health Share Ministries

• Initial Complaint

  02/07/2024

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  July 9th I was admitted to the hospital for C. Diff. After going round and round by email and getting different answers as to if **** had what they needed to pay the bill. Different times I was told they had all they needed and after waiting months I would be told they didn't have what they needed. So I would go through the motions all over again to get them what they needed. All while they were being paid my $700 plus premium per month. It has taken them 7 months to determine they were denying my claim for something other than the diagnosis from the hospital. How can they make a determination on something else that had nothing to do with my diagnosis and treatment and taking 7 months to do so while still collecting my premium. I would have cancelled them sooner. I feel they waited to make this determination until they knew it was after open enrollment closed hoping to trap me into keeping this insurance because I would not be able to find new insurance.

• Initial Complaint

  01/25/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  We signed up for a health plan in September with USHM. After inquiring to the company and telling them our very basic needs (my husband and I are healthy, go to the doctor once a year for preventative care, vaccines and bloodwork) and rarely - not even yearly - need to see someone for being sick and we would like a plan that covers just the basics. The sent us a plan which on the outside looked perfect. Ive had insurance my whole life and it was similar to most plans, just a little bit more affordable. In October, my husband started having some issues staying asleep at night and after a few weeks of not sleeping well, we tried to schedule him a doctors visit. A lot of USHM benefits seem to be found through apps. Those apps were not working for us. They would not accept our membership id... we kept getting errors and when contacting *****, they kept sending us to different numbers. We tried the teleheath route, which though because its through their apps, was not working so we asked for a list of providers in our area. They sent a pretty big list however, each provider my husband called they had no idea who USHM was and seemed to be as confused as us! This literally went on for months - back and forth with them - not getting the help or assistance we needed. Finally after me reaching out in early January, we for the FIRST time were told our plan is only for catastrophic incidents. That was NEVER mentioned, nor does any of the paperwork or our actual membership/PPO cards say that. As you can imagine, we were very upset and angry to have been manipulated into a plan that literally doesn't suit our needs--that of which I explained to one of their onboarding specialists in the beginning, yet they still shared this plan with us. Worst thing... the preventative care that should be provided, come to find out can only be done at "Minute Clinics" not the providers that they actually emailed us... but guess what, we dont have a minute clinic in our town! Stay away!

• Initial Complaint

  01/10/2024

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  1. **** billed me more than what was proposed to us. 2. We requested to start the healthcare program on the 15th, not on the 1st. After we received a bill that was higher than what was proposed, we attempted to cancel. Then they refused to refund our money because the salesperson marked us to start on the first. I already had healthcare and requested to start on the 15th at the time we spoke over the phone. These statements were recorded. I am disappointed over the deception of the salesperson, and I strongly discourage this healthcare organization.

• Initial Complaint

  02/27/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Back in early December, I slipped and fell injuring my left shoulder. I was referred to an in network orthopedic surgeon who after examining me, sent me for an ***. Results of the *** revealed a full thickness tear of the rotator cuff and also partial tears of the Labrum and Bicep Tendon. At that time, 2 pre-authorization forms were sent to UHSM on 1/11/23, one for authorization for the surgery and one for the therapeutic sling that is required after surgery. My doctor's ****** scheduled the surgery two weeks out which should have been ample time to obtain the approval. My doctor's ****** made multiple attempts to reach out to UHSM in attempts to secure the approval prior to the surgery date. **** denied the authorization for the therapeutic sling and said they never received the other authorization for the surgery. My first surgery date had to be cancelled and a new authorization form had to be filed for the surgery. In that new approval request, my doctor stated the results of the *** and that surgery would be required to fix the tears. On 2/1/2023, I was denied my needed surgical procedure due to "lack of conservative treatment". **** said that the doctor did not include enough detail in his notes about the need for surgery. On 2/2/2023 my appeal process began. My doctor contacted **** and requested a peer to peer consultation with a medical professional, but was denied. UHSM does not allow any direct communication with medical professionals. My doctor sent additional detailed notes to UHSM explaining that "No conservative treatment exists which will repair a full thickness tear of the rotator cuff". He also expressed that denying this surgery was grounds for "medical malpractice". On 2/8/23, the appeal was denied again due to "lack of conservative treatment" Since injuring my shoulder, I can't participate.in my volunteer work; I cant get a good night's sleep, my whole quality of life has been diminished. This company needs to be held accountable!

  Business response

  04/12/2023

  This complaint was initiated from this member to our organization. After further review, we have reversed the decision and the decision should align with member satisfaction. Case is now closed. 

  Customer response

  04/25/2023

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  09/16/2022

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  My family joined UHSM September of 2021. May 23, 2022 my 1-year-old was admitted to Childrens' Hospital in Plano, TX. As we were going through the admittance process, the hospital told us they do not have a contract with UHSM, but we called to ask UHSM and were told all hospitals are in their network. We were in the hospital for eight nights with our baby. He was diagnosed with para influenza, which had caused him to have croup, which then developed into pneumonia. In his medical history, a provider noted that he had had a case of croup and another case of RSV 10 months or so prior. Because of this, UHSM called his hospitalization a sickness due to a pre-existing condition. Since then, we have spoken to people at the hospital and our own pediatrician, and they all agree that a virus like that would not be considered pre-existing, especially since he is an otherwise healthy baby. Our pediatrician has sent an appeal to the insurance company, but we have not heard anything yet. A doctor from the hospital who sends their bills privately told us that they had reached out to UHSM with their portion of our stay, but had never received any word back. Not only has UHSM been ignoring those kinds of calls, but they have also been dishonest with us throughout this process. After at least 10 different phone calls since May, my husband was finally transferred to a manager at UHSM, and she told him our pre-authorization had been denied because of the so-called pre-existing condition. We asked her why nobody had told us before, as every single time we called they told us they were processing the claim and would have it finished by the end of August. She said that was unfortunate and those people would be talked to. Then we asked her for her direct line so she could help us moving forward, and when we called her line today, it was clearly a bogus number. We need help getting UHSM to deal honestly with us and the hospital.

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