I Beat United Healthcare
I want to share my experience dealing with United Healthcare over the last two years or so. I'm sharing this because insurance companies benefit when we stay silent. Also, I'm feeling petty!
The Setup
[May, 2022] I start a new, common prescription medication. Once a year, I need to see a doctor for a refill.
[December, 2023] I quit my job. This triggers a transition from my employer-sponsored Bank of America UHC plan to a new UHC plan. Same insurance company. Different plan.
[May, 2024] I go to the doctor for the annual refill. The visit takes less than 15 minutes.
At this point, there is no reason to believe this will become a project.
The Denial
[March, 2025] Atrium sends me a notice saying the claim was denied and I owe $200. The reason: UnitedHealthcare states I had alternative insurance at the time of service, and I needed to resubmit to my primary coverage. Yet, at the time of the visit, I only had the one insurance plan. The alternative insurance they are referring to ended in December 2023 with my last job, and was also administered by UnitedHealthcare.
The Battle Begins
[March, 2025] I begin what will eventually become 11+ phone calls across Atrium, UnitedHealthcare, and, eventually, unrelated third parties.
This phase is hard to summarize cleanly because it wasn’t clean. It involved:
- Being told Atrium was mistaken
- Being told UHC had a letter of termination of coverage
- Being told someone had the letter, but not being sure who
- Being transferred, disconnected, or placed on hold indefinitely
At some point, mostly out of desperation, I called Blue Cross Blue Shield who was my provider for dental and vision (i.e. the Premium Organs.) They were super helpful, despite being entirely unrelated. They told me what to ask for, and who the responsible party should be.
What I needed to do was call UnitedHealthcare, request a letter documenting the date of the plan termination, then send that same letter back to UnitedHealthcare. And, since it’s 2025, I had to send that letter that was emailed to me back to them via fax. So, basically the episode of Nathan for You requiring an easy rebate to be submitted from on top of a mountain.
The Waiting Begins
[May, 2025] Atrium sends the bill to collections since it has been over a year since the original appointment.
[May, 2025] I fax proof of termination. I am told it will take 8-12 weeks to process.
[June, 2025] I pay the collections bill. They totally got me! I was scared it would hurt my credit, and collections is just kind of scary.
[June 2025 to October 2025] Silence! No updates. I called and they received the fax and that’s all I knew.
The Escalation
[October 15, 2025] I formally appealed the claim and explicitly state my intent to escalate to the state insurance commissioner if it is not resolved.
[October 30, 2025] The claim was approved!
The Resolution
[December 4, 2025] A refund is issued.
[December 17, 2025] A check arrived in the mail!
From a 15-minute doctor’s visit to a physical check in my mailbox: ~19 months.
My Takeaways
A few things I learned through this irritating experience:
- The system assumes you have unlimited time, patience, and emotional bandwidth to claim what is yours.
- Only 1% of denied claims are appealed. These providers most definitely benefit from introducing complicated procedures.
- This could’ve been far worse. I “won” after just internal appeals. But, the next step is external appeals, or even a lawsuit. I don’t know how much more time I was willing to invest in this.
I think it’s also important to acknowledge this was mostly a pissing contest. We are talking about ~$205, which I am in a privileged enough position to not lose sleep over. But, I know a number of folks that have faced real, life-altering consequences from the structure of our healthcare system.
This isn’t a call to action or a suggestion for change. I don’t think I scratched the surface of challenges in this space. So, this is just a record of my experience, and maybe a little gloating about my victory.