Complaint Review: True Results

I received a call that True Results had processed my insurance pre-approval, and that I was approved for the Bariatric surgery, to schedule my appointment for the free consultatoin and begin the process. I went to my free consultation, the program was discussed, I was advised that the procedure was covered by my insurance as in-network, and that after further review, I had met the qualifying criteria for the procedure.

I was asked if I wanted to start the process right away, no further delay, and they would perform the ekg and breathing test, and I complete all of the paperwork questionier for the surgeon and insurance company. I asked if the ekg and breathing test was covered and was told yes, it was covered under my $25 copay as a doctors visit, and they would bill me if I did not have my checkbook. I said ok and had the two tests.  I was then advised to schedule the appointment with the surgeon and an xray, of which I did, and checked out good with the surgeon and xray.

A few weeks passed, I checked in on the process, was told they were waiting on a doctor to confirm my overweight but no fax returned for those weeks. I asked if they called doctor and was told no, they wait. I called the doctor myself and found they never faxed. I called True Results back and gave them the fax number again and they said they would fax.  I called True Results a few days later and was told they forgot to fax the request but would do it now.  I called the doctor myself again to confirm the fax was received. 

I wait a few more days, called True Results, was told I was still missing a year, I told them I had seen this doctor for over 15 years, to fax again. They did, but wrong dates. Again they faxed again and finally received the dates needed. Then I call the next week to see if all finished and schedule my surgery and was told the person that works the processing is out for a week and nothing will be done until her return. Only one person does this ?   

I call the next week, they told me she was back, would call me back, well, two days later, of me calling each day, I finally was able to talk to her. She told me they reconfirmed approvals and sent everything to the insurance. The next day they call me that the insurance wants me to call. I call the insurance and they say new clinical needed now, that in past 24 hours the clinicals changed with the carrier and my employer.  I called True Results, was told they were aware and everything is fine, they have taken care of everything, to expect approval within the next 12-15 days.

Two weeks later, True Results leaves me a message asking if I heard anything from insurance and how I was doing. I called my insurance company to find out the doctor was contacted about the change in clinical, that information is needed within the next 48 hours (2 days) or I am denied for not meeting the new clinicals. I called True Results, they played dumb, and only said they would work with their insurance team and notify my PCP to get the final info, and would call me back before our 2 day deadline was up..Well, no call, cannot reach them, nothing.

The quencher... I just got hit with an almost $2000 bill for my one Free Consultation office visit at True Results.  My surgeon bill was paid, but the one True Results visit they billed for 2 doctors, and the 2 tests, totalling almost $2000, of which my insurance company UnitedHealthCare would not negotiate a price and claimed it to be out-of-network, leaving me to owe full price under my deductible for out-of-network.  I did not see any doctor on that initial visit, only the technician that did the ekg and have me breathe in a tube twice for a lung test. The consultation with the nutritionist and billing was all supposed to be free. Who were the doctors?  Why was I billed when I was told all approvals for their visit, and tests were for in-network, and only required my $25 co-pay?

So now, no surgery, left owing almost $2000 when they lied, and I had to tell them how to do their job. If they did their own job, stayed on top of the faxes, followup calls, and had someone else who could do paperwork when someone is out for a week, I would have met the surgery approval original clinicals and had my surgery approved and paid for.  Now I have to find another program, or just try everything on my own.  I have severe arthritis in both knees and my hip, surgery would have been a Godsend. I am in so much pain and now I have to deal with this billing nightmare and loss of faith in their program.