UMR

I have been battling with UMR for over a year, and the experience has been nothing short of infuriating. Despite having submitted all the necessary documentation, including irrefutable proof via screenshots and fax confirmations, my claim remains unresolved. UMR continues to deny my claim, citing missing documents, even though I have provided every piece of evidence they requested. The situation is further aggravated by the fact that I have already hit my deductible and maxed out my out-of-pocket expenses, yet UMR persists in claiming that I owe patient co-payments for services that should be fully covered.

One of the most egregious aspects of this ordeal is UMR's faulty communication. The fax number provided on their website for claims submissions is invalid. When my healthcare provider attempted to fax the supporting documents, they were informed that the number does not work. This deliberate misinformation appears designed to ensure that crucial documents never reach the appropriate department, thereby stalling the claims process. Eventually, my provider found an alternative way to submit the documents, but they still do not respond.

Every time I call UMR, I am forced to retell my entire story to a new representative, who then promises that my claim is in progress or under review and that an escalation email has been sent. However, as soon as I hang up, nothing changes. The repetition of these empty assurances is not only exhausting but also demonstrates a complete lack of accountability and coordination within UMR's customer service.

Attached is a detailed breakdown that reveals a glaring disconnect between the services provided and the benefits I am entitled to. Despite meeting all my financial obligations under the policy, UMR continues to misclassify these charges and delay proper payment.

UMR's deceptive tactics exploit the goodwill and trust of their customers. As someone who has lived on three different continents, I have never encountered a health insurance system as disorganized and unresponsive as UMR's. I am posting this review on the Better Business Bureau website to warn others about the unacceptable delays, inconsistent communication, and apparent intentional misdirection employed by UMR. Potential customers deserve transparency, prompt service, and genuine care—qualities that UMR has sorely failed to demonstrate.

We paid over $1,200 to UMR COBRA in March, under the impressionbased on what their materials and representatives led us to believethat coverage would begin once they received our payment. What wasnt made clear at all was that any payments would be applied retroactively to cover a prior period (in our case, December), which we did not need, use, or intend to cover.

To actually obtain coverage for April, we would have had to pay for four months of premiums, most of which would have applied to a time period where we were not even using their services.

Thats over a thousand dollars wasted.

We called and spoke to a representative who admitted this is common practice, and advised us to send a signed letter requesting a refund for the coverage we didnt use. We did exactly thatonly to be met with a flat-out denial.

This may very well be a common practice for them, but that doesnt make it any less shady or deceptive, especially when we were clearly led to believe that coverage would begin upon receipt of payment in March.

Why would anyone in their right mind pay $1,200 in March to begin coverage in December of the previous year? It makes no logical or ethical sense, and there was no transparency about this process up front.

We feel misled, manipulated, and taken advantage of.

Their vague communication, misleading policies, and refusal to make things right raise serious concerns about the ethics of how they operate.

I would strongly warn anyone considering UMR COBRA to stay far away. Their practices are not only confusing but feel intentionally deceptiveand it wouldnt surprise me if theyre eventually hit with a class action lawsuit for these kinds of unethical business practices.

It hs taken my primary dental office including myself to get EOBs. From

November 2024 through April 2025, no EOB was sent to my primary dentist.

The dentist received credit by direct deposit, but no information sent to office for them to give me credit. We worked days that get information. Four times we ask for EOB and was told they would fax that day. Never happened.

Ask to speak to a Manager and was told 3 times

They would have manager to call within 2 days. There again no phone calls.

So guess who was getting payment, the Dentist, definitely not the Patient. So I am fed up and searching for dental insurance.

Through my employer, I have full (and somewhat decent) coverage, including some wellness benefits. Last year, I bundled and submitted my receipts for reimbursement, using the website submission feature.

I didn't hear anything for a ridiculous amount of time, and after calling customer service, the answer was to resubmit the claims, and they would eventually be entered into the system. Eventually, I was reimbursed, but it took several calls, lots of transfers between agents; basically, it was a huge waste of time. Fast forward to the end of 2024, I submitted (via the web portal) a set of 4 receipts for reimbursement. Surprisingly, it has taken at least 5 calls and nearly a month of waiting only to find out that the claims were just submitted and may take another 30 calendar days to process.

Again, the answer was to resubmit the claims (counterproductive, I think, since the system is already beyond the ability to deal with whatever was already submitted), no matter than I have a confirmation number for the original submission. Two or three agents told me to just resubmit, to call back, to call a different number, etc.

It will take them at least another month to process the claims, and even then, I'm doubtful that it will be done correctly. After last year, I'm not sure why I expected less of a runaround.

LITERALLY no communication! I submitted an authorization for a patient at the beginning of January 2025, but apparently it was voided because they hadn't used all initial 20 visits at that point, but I was never contacted.

The site I submitted the auth on didn't show that, only that it was still pending. I had to send a message to provider services through the UMR website and message back and forth for days to know that. Moving on, the patient did in fact use all 20 visits that didn't require the auth, so I submitted a new request on 1/22/25 and checked it every day for a response, but of course, nothing. It's the 30th.

I sent a message to provider services for a response, but it takes 2 days to wait on the turtles to check the messages. I call this morning, get a human, verify all patient details, they transfer me to the "right" department, some lady answers, but of course, she can't hear me and hangs up. So, I get the luxury of having to call back and go through all the garbage again. This time, I get transferred without issue, but this poor lady is confused.

She does reopen the case that was improperly voided, but she can't answer how the visit count went from 12 visits used during the original authorization, backwards to 8 when I submitted the next one. The patient was treating throughout the month of January. Fast-forward, now she tells me I have to wait up to another 7 days for this to be approved. UM, NO, I don't think so, I have already waited a week and because your people can't process the auth right, I don't want to wait another week and the patient shouldn't have to wait for their therapy!

The patient is post-op, keeping up with her therapy is extremely important for range of motion and strengthening. The supervisor ("Amanda") tells me that she will attempt to expedite to the nurse and get this approved ASAP and have someone call me to let me know it was approved. It shouldn't have to be like this!! You shouldn't have to fight your way through 5 different people to reach a supervisor for your voice to be heard!!

However, in the same breath, don't give up or give in. Don't allow TERRIBLE customer service to win!!!