Students give UnitedHealth poor reviews
Part 1
By: Jinny Cho
Posted: 9/15/09
Zack Brown was jogging on East Campus last August when he suddenly lost hearing in
his right ear.
"No loud noises, no trauma, it simply cut out," he recalled.
Brown, a fourth-year graduate student in environmental sciences and policy at the
Nicholas School of the Environment, said he went to Student Health the next day and was
referred to an ear, nose and throat specialist, who classified the condition as "a medical
emergency." Brown said he then underwent a brain magnetic resonance imaging to rule
out the possibility of brain cancer.
With two weeks of steroid treatment, Brown's inexplicable problem went away, and the
MRI results were negative for cancer.
But with medical bills of about $1,200, Brown said his problems were far from over.
"I called [UnitedHealthcare StudentResources] to check about coverage and they
informed me that hearing problems were not covered unless they were related to a
'disease process,'" he said.
Brown added that phone calls with UHCSR representatives were "hopelessly
unproductive," leading him to question why he has health insurance.
"What good is insurance if it doesn't cover something like this?" he said.
Many other students have raised similar complaints online and in interviews with The
Chronicle, bringing sharp criticism of UHCSR to the fore. UHCSR replaced BlueCross
BlueShield of North Carolina as Duke's Student Medical Insurance Plan's provider in
2008.
UHCSR officials said the company is in daily contact with the Duke Student Health
Center to refine the plan as requested by University administrators.
"We continue to work with Duke University representatives to adjust the [Student
Medical Insurance Plan] according to their guidance," said Susan Barry, director of
marketing at UHCSR, adding that "large plans often have transitional periods of
adjustment."
But in times of medical need, University students said confusion and frustration with the
new health plan have overshadowed what should be at the forefront of their attentiontheir health.
"What's remarkable to me in all this is that my wife and I are among the lucky ones-we
have medical insurance," said Matthew Whelan, a first-year graduate student in the
Divinity School. "And when we needed things to go smoothly-both being graduate
students, expecting and then receiving our first child-it was quite overwhelming to have
to deal with UHCSR in the way we did."
Pregnant and insured?
Whelan said he and his wife, fourth-year Divinity graduate student Natalie Carnes, found
fighting for maternity coverage to be taxing. Originally told that the birth center at which
his wife delivered was in-network, Whelan said the couple was surprised to later discover
that the service was out-of-network.
"It literally felt like a part-time job dealing with them over the phone this summer in
order to resolve the manifold bills we kept on receiving from providers, fighting just to
get UHCSR to cover the things their policy states that they cover," he said.
Carnes noted that health care providers seem to be facing difficulties under the new plan
as well.
"One thing that has surprised me in this process is how frustrated I have seen health care
providers get with UHCSR, too," Carnes said, adding that two hospitals she has visited
have expressed confusion and frustration with the current plan.
Jered Wells, a second-year graduate student in medical physics, said he expected his
wife's UHCSR insurance to cover the majority of her pre-birth care, but then the couple
was billed $721 for a fetal ultrasound. Upon probing further, Wells said the details he
unearthed were surprising.
"I found out that Duke had billed my second ultrasound as an X-ray," he said. "Being as I
am a student in the medical sciences, I should know that an x-ray is certainly not
equivalent to an ultrasound. My inquiries to [UHCSR] indicated that, due to the mix-up
in billing, [UHCSR] was unable to cover the cost of the procedure unless a full prenatal
workup and ultrasound results could be provided by the hospital."
Wells said the insurance company paid the ultrasound bill six months later.
Searching for doctors in Beaufort
Students at the Marine Lab in Beaufort, N.C. said they have been frustrated with UHCSR
guidelines they feel are unfair to those who spend their time outside Durham.
Myriah Cornwell, a fourth-year graduate student in the Nicholas School living at the
Marine Lab, said BlueCross BlueShield of N.C. provided students with more health
providers in the area than UHCSR does. She said she and her fellow students in Beaufort
brought their concerns to UHCSR, which asked for a list of all providers in Carteret
County.
Michelle Blickley, a sixth-year graduate student in the integrated toxicology program at
the Nicholas School, said she and other students at the Marine Lab then submitted 10
names of medical providers near Beaufort to UHCSR.
"Out of the 10 or so names we submitted, only two have been added to the program," she
said.
Blickley noted that the lack of access to physicians has been very inconvenient for her.
"When Duke switched to UHCSR, I had to change all my doctors because none of them
accepted UHCSR," she said. "Even more upsetting is that the physician list on the
[UHCSR] Web site only lists 39 doctors within a 30 mile radius [of the Marine Lab] that
accept our insurance."
Blickley said UHCSR representatives told students to look within a 50-mile radius.
Cornwell also said a clause in the health plan that limits students to one medical visit a
day is unfair to those in Beaufort.
"Many of us Marine Lab students schedule doctors' appointments in Durham-since our
coverage in Beaufort is so dismal-and we like to do them in one day since it's out of our
way," she said.
UHCSR is re-examining the clause, said David Kahler, Graduate and Professional
Student Council treasurer and Student Health Insurance Advisory Committee member.
Miscommunications
Other problems stem from-as Brendan Nyhan puts it-"administrative incompetence."
Nyhan, who graduated last year with a doctorate in political science and now researches
health policy at the University of Michigan, said he was billed for his two-year-old son's
vaccination-a charge UHCSR did not cover because his son was listed as his spouse.
"We determined that I was being charged higher premiums than I should have been, since
insuring a spouse is more expensive than a child," he said. "Apparently the fact that my
son was two years old didn't tip them off."
Other administrative problems arose from confusion on Duke's end about where claims
should be sent.
Cornwell, who does research at the Marine Lab, said that initially, every medical claim
she filed was denied.
"Every time I contacted the UHCSR help line, it was as if I was talking to a wall," she
said. "I explained my situation, and they denied ever receiving a claim and offered no
help in dealing with the hospital or paying my bill."
Jean Hanson, administrative director of Duke Student Health, said that from August to
October of last year, the Duke Patient Revenue Management Organization sent student
insurance claims to the main UnitedHealthcare office instead of the college-specific
subdivision of UHCSR.
But Cornwell said she believes the problems could have been resolved quickly.
"At no point did anyone at either United branch figure this out or pass along my claim to
the right office.... It was as if they were forbidden from talking to each other," she said
Hanson added that the error was not unique to Duke. In a November 2008 message
posted on the GPSC insurance forum, Hanson wrote that because the problem was so
prevalent among other schools, UHCSR developed an information sheet about claims
submission, which is now posted on the Student Health Web site.
She said in an interview that claims submission problems have been addressed and are in
the process of being resolved.
For some students with other options, changing insurance providers appears to have been
the simplest choice.
Wells said he and his wife decided to leave UHCSR six months into her pregnancy.
"My wife and I abandoned the Duke system… in order to avoid the hassles with the
insurance," Wells said. "Needless to say, the remainder of the pregnancy was worryfree."
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