Contributor ⭐

AARP medicare claims are not showing

Forum|Forum|1 year ago
April 13, 2025
11 replies
4294 views

It's been 2 months now and there are 3 known claims that are not showing up and 1 claim that is showing up but it's still in process more than 60 days later. I called UHC medicare advantage and they said they haven't gotten the claims. I called both providers to verify they filled within a week and shows pending insurance. UHC representative called my providers to ask them to resubmitt the the claims. That was 2 weeks ago and still not showing as claims. Can someone please explain why this may be happening?

GailL1

Community Champion ⭐⭐⭐

If you have a UHC Medicare Advantage plan then you need to check with them on whatever the problem might be -

Make sure the providers have your p;a name and account number correct and they know where to send the claim. Make sure they are in your plans network unless your plan is a PPO and you are using them as out of network.

There is nothing that AARP or Medicare (CMS) can do - your Medicare Plan is with United Health Care - it may bear the AARP name but that is just for marketing and royalty reasons - UHC processes all the claims.

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

T

TomT237341Author

Contributor ⭐

These providers billed the UHC in January and were promptly paid. Now in February they don't show. When I called UHC, they said the providers didn't file a claim so called them and verified the claim was filled correctly so asked them to file again. Fast forward 2 weeks and they still are not showing. These are two separate providers so I find it hard to believe that they didn't file the claim correctly. Again, these providers filed claims in January and those claims went through and were paid. This has to be a problem with UHC. but there customer support continues to say they didn't get the claims. Soon those providers will bill me directly. I don't know what to do and neither does UHC. I'm just looking for some guidance here.

GailL1

Community Champion ⭐⭐⭐

@TomT237341

Don’t show where???

You said the providers were paid - so what is the problem? The providers are saying that they didn’t get paid?

I am having a hard time understanding the problem ?

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

papawofboo

Community Champion ⭐

You want the simple answer, here it is. Years ago the biggest complaint that people had was that the bag boy had put the eggs and bread in the bottom of the bag and put the gallon on milk on top. Guess what, that shoddy workmanship has worked its way into the medical field and all the other fields. Use to people went to work and did the best job possible, no more, over 90% of the people out there have the attitude, "That's good enough, let it go."

I have seen it take a year to get a claim filed

My #1 rule is I don't pay until I have an EOB, that kind of gets the attention of the doctor's billing office. They in turn talk to the insurance dept. Then it all comes together, and you get an EOB. I'll bet you a nickel the problem is in your doc. office.

Papaw of Boo

SummerOnTheWay1

📎 Papaw @papawofboo , that is wisdom!!! 👍

YOU WROTE: My #1 rule is I don't pay until I have an EOB, that kind of gets the attention of the doctor's billing office.

Take care,

Nicole 👵

GailL1

Community Champion ⭐⭐⭐

@papawofboo

That ‘s kind of good advice but just make sure that the claims are yours. I have been working on (2) separate beneficiaries who have had their Medicare claims compromise by DME fraudulent providers to the tune of $ 20,000 which Medicare paid them.

The services were for those Continuous Glucose Monitors and the transmittal of data to the doc. These transmissions are a big fraud area where lots of payments are being made to bad players (criminals).

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

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