News 4 Investigates: Daily Briefing

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Problems with getting Payment for Presciption Drug Costs

by Chris Nagus

KMOV.com

Posted on January 10, 2012 at 9:59 PM

Updated Tuesday, Jan 10 at 10:25 PM

(News 4 Investigates) -- A billing error at a Wal-Mart pharmacy led to a nightmare for a disabled Missouri woman.

After wasting months trying to get the problem solved on her own, she called News 4 for help.
Amazingly, once Chris Nagus got on the phone, problems started getting fixed.
 
“I keep getting rejected, this is one from September, it’s just not fair to do people this way,” says Dorene Whaley.
 
In July of 2010 she switched her insurance from Mercy to United Healthcare.
A month later she got her prescriptions filled at a local Wal-Mart, but the store billed her old insurance provider.
So she had to cover $367 out of pocket and getting reimbursed from United Healthcare’s prescription partner Medco has been anything but easy.
 
Whaley has kept detailed paperwork and detailed notes.
“I think I ended up talking with 7 people on Wednesday, two and half hours” she told News 4.
It's a battle she has been fighting since April of 2011.
Some people might just give up over $367, but Whaley needs the money to cover 11 daily prescriptions. Most of her disability check is used to pay for medication.
 
So Chris Nagus called United Healthcare and spoke with a Public Relations representative in Chicago.
He immediately started working on the problem. 
A couple of weeks later Whaley received a check for the full amount after getting rejected trying to fix the problem on her own.
 
The insurance company gave News 4 this statement on the situation: "United Healthcare strives to provide timely and accurate service to our members, and we are grateful this billing error was brought to our attention. We have corrected the issue, which resulted in part from a change to Ms. Whaley's health plan coverage."
 
Again she has now been paid in full and credits News 4 for getting her money back.

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