Re-credentialing Nightmare with United Healthcare

Our office was once undergoing some re-credentialing issues with United Healthcare. One provider with the insurance had over $16,000 in aged claims. When we would send claims for approval the representative at United Healthcare continually denied them stating he was out of network. Having reached a roadblock I called Careington. They informed me that the provider was in network as of February 4th of 2019.

With this information I called United Healthcare once again. I spent multiple hours on the phone with the provider relations, and ultimately was told that there was nothing that they could do. This seemed odd as the records of United Healthcare did not reflect the information that I was given by Careington.

For the next 6 months I called anywhere from two to three times a week trying to find a representative that would help. Finally, I called Careington again and demanded that they stay on the call as I contacted Provider Relations at United Healthcare. What preceded was a long phone call with both sides, and through it all United Healthcare finally found the paperwork that Careington had been sending them, demanding payment to us.

Once all was said and done, United Healthcare paid all of the providers claims in addition to $1400 interest for late payment.

Dental Billing Tips and News for Pros; Edition #145