United Healthcare Changes

In my area (Washington, DC Maryland suburb) United Health Care appears to have made significant changes in their reimbursement schedules (October 1)and provider lists. Three firms I had dealt with Lincare, Neighborcare, and American Health Care at home appear to have stopped accepting United insurance (i.e. they told me they found the rates unacceptable). Does anyone know just what the changes are?

New providers that have become available appear to be SleepMed Therapies and Apria. From talking to SleepMed Therapies and from their web site they appear to also do sleep studies (possibly a different legal firm but from talking to them one organization). They apparently have a different model from the other firms I have done business with. They want you to make an appointment to get a new machine (the others would bring one out to you with a therapist) or a mask (I did not press them on their willingness to send the mask by mail because their nearest location is 4 minutes away according to Mapquest and I would appreciate talking face to face and having a chance to try a mask).

From an administrative viewpoint they are refusing to sell me a mask without a copy of the sleep study. This is at least a nuisance to get to them.

Does anyone have any experience with them?

I tend to be supportive of the idea of visiting them rather than having them come to you since it cheaper and hopefully some of the savings will reach us. I suspect the custom of having the therapist come to you arise when they were typically setting up an oxygen apparatus for invalids who could not travel.

If you go to their offices they should have a larger stock of masks than when a therapist drives out to you and typically has only one or tow with them (pre-chosen from my experience). While other firms have offered to have you come out (or suggested it) they typically have been in inconvenient locations (low rent industrial areas and often have not appeared to be set up to do fittings). This firm appears to have several locations in the area and for the nearest to me to be sharing an office (I do not know who with)which a therapist comes to every Friday. The others I had dealt with typically seemed willing to sell you a mask via mail if you did not visit them and that gave little scope for trying several (and I have been told if you open one you cannot return it).

I would appreciate any advice any one may have to offer. I do not know if this a countrywide shift in their policies, but it may serve to warn others that their next attempt to purchase anything may produce an answer from their customary supplier that they no longer take United (and then after finding a new firm) that additional paperwork will be needed.

ProfessorEd,

I have United Health care and they were cut off by Lincare, my first DME. I went then to American Home Healthcare and have had no trouble with either the DME or the insurance.. I live in Atlanta and it may be the difference in the area. I order masks to try and the RT brings them by. I love them.

Just my .02,
Kevin

SleepMed seems to be a growing national chain. My ENT sent me to them for the sleep study (turns out he also interprets their studies) and they have provided equipment for me and my husband.

On the plus side, the people were very helpful and the sleep lab immaculate and comfortable. The mask fitting and machine setup were very thorough. They gave me the fully data capable machine that I asked for.

The problem: According to the local SleepMed office, they only replace hoses, masks and cushions every six months. I sent them a link to the Medicare reimbursement schedule which they have forwarded to the head office. We are still waiting to hear back from them (I emailed them last Monday) as my email works its way up the chain of command.

If they don't accept the Medicare schedule we will change DMEs, but I can't imagine them not revising or clarifying their policies.

They do have a website where they sell the equipment online.

Susan

Lincare called me a couple of months ago and said they were no longer working with United Healthcare. Said I would get a call tag in the mail and would need to box up my equipment and return it to them.

They suggested I start looking for new equipment, possibly through Apria.

Never got the call tag and have gotten 2 bills in the mail since the phone call so I assumed Lincare is still onboard with United.


Bill

I also have United Health care out here in Oregon. My only choice was Apria according to United.

I am not impressed with Apria at all. They have not been helpful on choices of products. If I hadn't found this website I would have been totally lost. They take 3-5 days to return calls. Not impressed.

Good luck

In NY (Long Island) have UHC chice plus and I had I think 55 dme's within 20 miles (including duplicates and prostheics).
WHen speaking to my DME yesterday, they said UHC was one of the better ones (new machine every 36, new mask every 3 new parts every month (gel, strap, hose)

In the DC area, try to see if Roberts Home Medical is one of your choices. I use them and so far, have had no problems. When I went in for my machine, they showed me how to use it, and let me try on every mask they had. It was a one-on-one appointment, not a group appointment like Apria uses. So far, I really like them.