AARP Eye Center
I have AARP United Healthcare Medicare Advantage HMO health insurance. I have exceeded my $6,700 out-of-pocket maximum for last year.
In August of last year I made a prepayment of over $900 to an in-network hospital for an outpatient procedure. This service and my prepayment have never shown up on a monthly EOB statement. United Healthcare says they forwarded the claim from the hospital to my HMO since it is the HMO's responsibility. The HMO says they have never received the claim.
The HMO claims dept now has an answering machine on and never returns my calls.
It is possible that I am owed $900 since I am over the out-of-pocket maximum for the year. What can I do to clarify this?
I have an itemized statement from the hospital showing that I paid that $900 pre-payment as well as my credit card statement. United Healthcare says that the coding on the statement is incorrect and they need to have the hospital correct the claim but that has never happened.
What do you have to show as proof you made the payment?
How did you pay the $900? Do you have a bank statement along with a copy of the check if you paid by check? Do you have a Credit/Debit card statement that shows you made the payment? What did you get from the hospital you made the payment to?
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