1 /5 Chuchi: They should get Zero stars!!
They make everything difficult beyond belief!! And, for aging handicapped seniors this is especially painful to deal with them. For example, when my mother (89yrs old, handicapped and almost blind but mentally fit and otherwise active) had a stroke, she needed physical therapy, occupational therapy and speech therapy. Not only do they have few providers to choose from, every few visits they have to do another eval, then they often discharge way too early before the patient has had a chance to recuperate and you are required to get another doctors request for continued services and you have to wait another several weeks for Optum/Monarch to approve, then you have to wait for schedules to open up again and start over. Meanwhile, youve lost ground.
Another instance was when my mother was being billed for services which were supposed to be covered but neither Optum or Monarch were helpful in getting it resolved so her doctor kept billing her and threatened to cut her off. They have no patient advocates or anyone at the top to help you. They routinely tell you you have to call another department.
Another serious case was when she had an eye surgery to protect the remaining vision in her only working eye and following the surgery she lost most of her vision. We wanted a second opinion, but they didnt have any other eye surgeons to provide such an opinion. So, we insisted they pay for her to see a non-participating provider. They fought and fought and after days of calling anyone we could get ahold of at the highest levels, Blueshield and attorneys, they finally acquiesced and sent an approval to the doctor we had requested.
A few months after my mothers visit, she was sent a very large bill from the 2nd opinion eye surgeon. They told me her insurance only paid for a pressure check and refused to pay for anything else. They knew full well my mother needed a complete and indepth evalutaion but again, they left us paying the bill. Very dishonest and unethical.
If I have to fight like I do for my mothers services at my age and health, how is any senior or handicapped person supposed to manage their own care on their own?!?
The only reason my mother stays with Optum/Monarch is because she loves her primary care doctor and its too hard to switch at her age.
STAY AWAY FROM MONARCH & OPTUM AT ALL COSTS!!!! THEY ARE HORRIBLE TO WORK WITH.