Walkthrough of UHC’s claim reimbursement form game | Hacker News Reader

Walkthrough of UHC’s claim reimbursement form game

github.com

172 pointsmyuhcadventure47 comments

It's appropriate to pick on UHC here but a lot of this insanity derives from rulemaking by Health & Human Services and Center for Medicare/Medicaid Services with a healthy dose of legacy everything thrown in. Even if you really wanted to fix this in an overall way you cannot without acts of congress, rulemaking by federal departments and individual legislation in each of the states and local medical jurisdictions. UHC has no inventive to make it easy to submit a claim but likewise they realize the futility of expending a lot of resources to make it the tiny bit better that current regulation would permit.

I am author of Hacking Healthcare for O'Reilly, 20+ years experience building and managing health systems

Thanks for writing Hacking Healthcare! It's been an incredibly helpful resource working in healthtech.

Hmmm almost none of the process has to do with HHS. UHC could make this a lot easier. That's why we submit via mail instead - that makes it their problem.

> UHC has no inventive to make it easy to submit a claim

Interestingly, though, they do have an incentive to make it hard to submit a claim!

Maybe, but, even so, how is it that they manage to be so much worse about this than BCBS is?

I know it's really fashionable to blame the government for everything but the government doesn't require broken websites, confusing workflows, and excessive redirects.

I submitted a claim with Oxford (UHC subsidiary) and got the most “I can't believe it's not phishing” email as a result. It came from a GoDaddy-parked domain (oxfordteam.com), and it claimed to be a “secure message” in the form of an attachment. The crazy thing is, it was entirely legitimate.

I kept a screenshot: https://twitter.com/paulgb/status/1390331121544671233/photo/...

Ahh Cisco Registered Envelope Service! I reported that internally when I worked there, and I wasn't the first.

You'd expect this to be just some ancient software, but I found an internal Jira where someone was provisioning dozens of new instances all the time as of 2021.

It's so bad. It conditions users to open .html attachments from unexpected email addresses AND enter passwords into the webpage!

I have an insurance where you have to submit your reimbursement forms via mail. For some reason this has been quite challenging to me (printer, stamp, envelope etc.) and I didn’t submit things.

A provider pointed me to reimbursify which made it way simpler as you pay per claim and it just mails the reimbursement to the insurance. I think this reimbursify may be also helpful in cases like this if you want to speed run your reimbursement submission :).

Note: I am not affiliated with reimbursify but just a happy customer even though the UX&app are somehow clunky. Still better than the other options.

Sometimes it's actually easier to do this kind of stuff by mail. It's archaic, but most of the inefficiency falls on the other end. Same goes for dealing with banks, IRS, anyone who doesn't have a choice to deal with you (or you with them).

Send them a letter and make them figure out what to do about it. No need to wait on the phone and be transferred around or search through hundreds of menus in a poorly designed app.

So in Canada, you go to the doctor. You give them your health card. Then you leave. That's all.

The doctor uses the standard provincial billing system to get their money.

This seems far more exciting though!

The OP is more comparable to the system the doctor uses to get paid by the provincial health agency. A patient would only use this if the doctor refuses to deal with the insurer for some reason.

This misses the part of the game where the doctor's office has you fill out forms giving them a bunch of the same info they already have. Twice. In the same visit. This may take 20 or more minutes. For no good reason whatsoever.

Then the ongoing ARG portion where you have to repeatedly sit on hold for hours with the provider's billing department, insurance, and the state insurance commission and/or your congressperson's office, to finally get all the billing sorted out without getting screwed, all while receiving all kinds of scary letters that the people on the phone will tell you to ignore.

[EDIT] Oh and I bet the Canadian version of the game doesn't even have some of the greatest antagonists of the American edition: the people whose entire job is to wander around emergency rooms bugging very sick people about payment and insurance.

>"Oh and I bet the Canadian version of the game doesn't even have some of the greatest antagonists of the American edition: the people whose entire job is to wander around emergency rooms bugging very sick people about payment and insurance."

Most, if not all the provinces do actually charge people in certain groups (tourists & recent immigrants) for medical care.

>the greatest antagonists of the American edition: the people whose entire job is to wander around emergency rooms bugging very sick people about payment and insurance.

Lol yes! One time I woke up with debilitating nerve pain shooting down my writing arm and went to the ER.[1] One of those people kept bugging me until I snapped and said, “I am totally happy to fill that out, just the moment my arm is functioning again.”

[1] Yes in retrospect should have gone to an urgent care, although I suspect they wouldn’t have been helpful either.

That is how it was in the US with private insurance 30 years ago. But then everybody involved bulked up so they could improve shareholder value (i.e. executive comp).

Except for things the government doesn't cover that your private insurance covers.

Family members have had plenty of denials and crappy paperwork too.

And just like the US, paying cash is often the easiest path forward.

Same in Australia for most doctors (bulk billing). You usually only have to give them your card once.

If your doctor doesn't bulk bill though the process becomes more difficult.

You have to go onto a government website (fairly modern one), and upload your receipt for reimbursement within a few days. Or if that's too hard, just visit a local medicare office and they'll do it for you. Tough!

Fun fact -- I have UHC, and noticed that one of the domains in the redirect party as soon as you login is Adobe ....

>and noticed that one of the domains in the redirect party as soon as you login is Adobe ....

It doesn't look like it. I slowy scrubbed through the ChoosingForm.mov video, adobe isn't in any of the domains. It's only present as a query parameter.

https://imgur.com/a/9E4mrrU

Just cleared the inspector panel after loading login page, and entering my login information, hit submit, and waited for things to settle after the home page load.

Adobe, Facebook, Google, etc. All told that I just logged into Health Insurance account. Or Given more details. shrugs.

I saw this too. How is this not a HIPPA violation?

The fact that you have health insurance with UHC isn't PHI, which basically boils down to "your chart plus specific billing information". It's more complex than that, but that will steer your intuition in the right direction.

My guess would be that they're using Adobe Fonts, which is a pretty popular service for web fonts.

That's a good guess, but I know a couple people who worked for Optum and they told me that they use Adobe Experience Manager [1] as a CMS to allow business and marketing folks to change content. I bet that's what the the Adobe redirect in the URL bar is referring to.

[1] https://business.adobe.com/products/experience-manager/adobe...

As someone who also had to support a large org moving to this (oh god why), I strongly agreez

That wouldn't require a browser bar redirect though. You just include fonts in your CSS or HTML, the user never sees it.

> When it opened the new tab, I copied the URL from there and pasted it into Firefox! Success!

It sounds like the trick to get around Psycho Mantis' infuriating "I can read your mind!" gambit.

Logical conclusion: UHC hired Kojima to make their claims process more enjoyable.

Lol I get the feeling that even Kojima would balk at the absurdity of such a process.

From the way the author explains the data they are required to enter, it sounds like a HCFA 1500 form they are completing, which is a standardized form. It is not simple for first timers, and it looks like UHC's web-based implementation might overcomplicate things. Youtube has some good overviews of how to complete the form. With the actual paper form in front of you it makes more sense (the form also includes definitions and instructions on the back). Many providers will provide the completed form for you after payment for easier reimbursement, but submitting paper as opposed to filing electronically, at the expense of a quicker turn around time.

> Youtube has some good overviews of how to complete the form.

This is the most unhelpful comment Ive seen in a long time. YouTube has billions of videos, and now that downvotes are hidden, its quite difficult to even determine what videos are of any value.

I actually thought this was a game as I was reading it. In the same vein of Papers Please.

Utterly horrifying.

Not defending this, but what you are doing is entering claims information exactly how a hospital / clinician would have to. A lot of this is done automatically by software now. This isn't a dark-pattern, it's just slapping a shitty user interface on top of a standard claims billing process. It's sort of like using POSTMAN to interact with an API.

Then why can’t customers like him get the UX helpers that hospitals would have. Presumably they’re not swapping browsers all day?

It's very likely that the UX used by the hospital workers is not browser based.

Well, they're using a single Approved Browser (perhaps IE 6.0?) instead of those weird Safari and Firefox things.

But on a more serious note I wouldn't necessarily assume that any "UX helpers" exist, it's plausible that some overworked healthcare worker is using the exact same system and just has more experience in doing so.

This is great. I submitted my first claim form a couple of weeks ago and was dumbfounded by how difficult it was! Great job.

I enjoyed this darkly humorous tale in the same way I enjoy "Dr. Strangelove".

One of the best movies ever made. I watch it at least twice a year, sometimes more.

With Peter Sellers, Slim Pickens, and Sterling Hayden, there is always something new in their delivery that you pick up. The same with Kubrick and Adam's sets and cinematography...

It also has Peter Sellers and Peter Sellers!

It was also supposed to have Peter Sellers in it, but he twisted his ankle and couldn't do the role.

Slim Pickens was the perfect choice for Maj. Kong; Sellers could not have pulled it off.

> Slim Pickens was the perfect choice for Maj. Kong; Sellers could not have pulled it off.

I understand they never told him it was a comedy.

That is correct. It is really interesting to see his interpretation of the character - to me it is the best and most humourous of the entire movie.

...and a very young James Earl Jones, in his film debut!

Looking forward to the walkthrough for the sequel: The Appeals Process.

The best bit with the Safari struggles is that UHC is Apple’s PPO provider. What fun!

I get multiple “update your email address” postcards from UHC a week. Nothing stops them.

I am glad we have this superior system than the terrible systems in socialist Europe, Aussie, or NZ.

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