Edited Date/Time
12/4/2024 7:04pm
I understand!
Thank you for choosing United Healthcare for your healthcare needs. After a careful review of the claim submitted for emergency services on December 4, 2024, we regret to inform you that your request for coverage has been denied.
Our denial is based on the following findings:
1. Lack of Prior Authorization:
Our records indicate that you failed to obtain prior authorization before seeking care for the gunshot wound to your chest. While we acknowledge the emergent nature of the situation, our policy requires that all non-preventative services, including “unexpected chest injuries,” be pre-approved through our 24/7 Prior Authorization Hotline. Unfortunately, our hotline received no such call during your ambulance transport or at any point before your admission to the emergency room.
2. Failure to Prove Medical Necessity:
The submitted documentation does not sufficiently demonstrate that treatment for a penetrating chest wound meets the definition of “medically necessary.” Our guidelines specify that life-threatening conditions must be substantiated with a second opinion from a network provider, preferably before care is rendered.
3. Alternative Options Not Explored:
Based on our retrospective analysis, alternative, more cost-effective treatment options—such as a virtual telehealth consult or at-home first aid—were not attempted prior to your emergency room visit. We understand that you were actively “bleeding out,” but this does not exempt you from exploring lower-cost care pathways.
4. Out-of-Network Care:
The emergency room where you received treatment is not within our network. While City General is geographically closer to the location of your shooting, our network partner, DiscountCare Clinic, is only 25 miles away and equipped with staplers and gauze for such injuries.
Next Steps:
You may file an appeal within 30 days if you believe this decision is incorrect. Appeals must include:
- A notarized letter from the attending physician, explaining why you thought you were entitled to not bleed to death while waiting for approval.
- Evidence that your injuries were, in fact, serious enough to merit immediate attention, such as photos, videos, or live reenactments.
We encourage you to familiarize yourself with your plan benefits and utilize in-network providers for future incidents. Please do not hesitate to reach out to our customer support team if you have questions about this decision.
Sincerely and in good health,
United Healthcare
P.S. Remember: Preventative care is the best care! If you’d like, we can help you schedule your annual physical or connect you to a mindfulness seminar to prevent future traumatic injuries.
I read they have been using an ai program to deny claims that was found to have a 90% error rate. Convenient for them…
Have they found the guy yet?
They dropped me like a hot potato last year when for the first time in my life my glucose levels were pre diabetes levels. Was with them for over 10 years.
Real world justice i bet it’s motivation was.
You ruin enough peoples lives, eventually one sees fit to level a score or worse.
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Yeah, I certainly don’t condone what happened, but I kinda understand why it happened.
Stay classy non moto
You too, lappedrider.
Pretty classy to deny millions of claims and let people die. Fuckwhit take pal.
My health insurance is through a UnitedHealthcare company and they’ve paid out gigabucks for my cancer care with only mild hiccups. So go ahead, celebrate the murder of a father of two.
Maybe he knew some things about his company that some people with a vested interest didn’t want other people to know.
He was being investigated by the DOJ for violating anti trust laws and was also being sued for not disclosing the investigation to investors before the media reported on it causing investors to lose millions of dollars.
Not only did they not disclose the investigation, but CEO Brian Thompson and others sold all their shares, making millions of dollars.
Watch the movie "I care a lot" .....
I don't condone what the killer did.... but you can see how people who fuck over the little people, get rich from doing it and are protected from prosecution become a target when you fuck the wrong person.
A disgruntled investor hiring a hit man sounds more likely, than somebody who was denied a claim.
Finally some good news in the world. Insurance co.s r scumbags ther,ll deny your work injury with witnesses & video, etc. extremely crafty investigators creating made up denials. I,m out 2 mil in work injuries. A pre existing condition exists for everything. A pal lost his high paying sales job in 09. On my 1 day off I coached him on how to get a job in sales in ND. Oil industry. He landed a job a rep at 3am he was getting some 100 lb parts out of a truck. Slipped & fell he broke ribs, ko,d a molar out he hit so hard . Had a severe concussion, broken wrist etc. . In -40 degrees. Insurance denied him saying he was a kicker in d1 football at Iowa caused the preexisting condition. He had a lot of trouble for months doing anything like walking, speaking. I felt like crap for helping him.
I just had a guy 75 tell me how bad he was screwed over by United Healthcare last Oct. Warning my wife and I " Whatever you do make sure you don't end up with United Health care once you retire ".....
You know you can look up your claim adjuster that denied you rt ? They usually hv a link in account plus other social media . Which is Really stupid. Because now you know there spouses names, other family names. Where they live etc. There the scum of the earth to destroy people of everything they have. That’s why More Crafty people exist in Chicago & the Northeast . To get some of your money back . Or well more like add more money to the claim . But not against yourself. Capiche. Look at there link en account pic they know it screams I just made a Huge mistake. A pic of fear
I get my own hc I do remember United being a choice. I had them at done w2 jobs Totally worthless crap. Bored last night I walked around the ts. A Indian guy was sitting outside his vape store. He got excited thinking I was a customer. I said I,m just checking stuff out. He wanted to hang out & chit chat. We walk into the store inside the ts . We joked around & I see bags of edibles of all kinds. I say u sell a lot etc. he said yeah even too old people. A 70 yr old bought a bag of cookies 10k mil gram & ate 2 . His daughter found him with his head on the table with no paulz. She called 911 paramedics & police showed up. They said he was dead for 3 minutes no vital signs . Then he woke up . Haha the Indian kid said the guy smokes weed too . Where laughing I,m Wow could u imagine how high he was to die. The 70 yr old came back to the store & told the story to him. He said u should’ve told me not too eat 2 .
Pit Row
Hanging around the site all night long ??
This wasn't professional.
It was personal.
It's so very easy to see how someone gets to the point of such extreme hopelessness.
Joey, your last line in the quote above speaks volumes. So very true and a dark and scary place to be.
My daughter works for them, she sent me out a text as soon as she found out. She saw him last week at work.
Amateur hit clearly a disgruntled individual not a professional.
Fuck that guy. Merry Christmas to all the families he fucked over with claims denied. I wonder how many families lost a loved one due to being denied treatment or, care. #KARMA
My employer used United Healthcare for a year. Their rates increased come time for renewal more than any other company. Nearly double. I won’t go into details but, I got screwed more than once by them.
Wirh a silenced weapon…?
I watched my grandmother die slowly of cancer as a kid. Her healthcare provider dropped her the minute the word cancer was mentioned. Paying for EVERYTHING out of pocket, my grandfather sold his cabin, motorhome and, ultimately, his house we lived in.
Granted this was in the 90’s but, I don’t think much has changed in regards to long term treatment. They just bury you with paperwork and, deadlines these days.
Easily obtainable.
It’s this kind of shit that needs to equate to politicians and insurance execs being hung in the public square.
I do travel nursing for a career so insurance is an insure for me. I tried to buy insurance outside so I don't always have to be changing, This route is more expensive but one would think better as you never have to worry about coverage. I like to take 4-6 weeks off in between contracts so it provided some security.
I can't even get outside insurance that is worth a shit because I take gabapentin. Regardless of why you take gabapentin insurance links it to diabetes. I had a pretty bad hip socket/ruptured bladder/compound distal femur fracture and after surgery I was left with a great repair of all that but it left me with left foot nerve damage. That 's why I take gabapentin but for insurance reasons I have diabetes and there was no way to fix that. I tried.
So, now I just let the travel nurse company insurance expire and pic up cobra for a couple months when needed. Yes Cobra is a little more expensive and there is about a 3-4 week before they send the damn cobra paperwork. Like now I am in that lull (finished contract 2 weeks ago and will return after new year) waiting on Cobra paperwork. if something happened they would still pay as the go back the effective end date but you would have to pay out of pocket then get reimbursements. I don't want to do that bullshit. For this reason I am not riding mx until I get the paperwork. I wish it would hurry the fuck up, lol
Damn. That SUCKS. Sorry about your situation.
Some crazy questions, maybe? Is there a way to “self-bond” for medical coverage? Would that have tax benefits? Or…can you get a life insurance policy that includes major injury coverage?
I am not a big gun guy but the fellas at a hunting message board i frequent seem to think it was amateur because
-the gun jammed a few times?
-he didnt have gloves on?
-he left spent and unspent casings on the ground with his dna on them?
Just passing on what they said.
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