Tuesday, November 10, 2009

Shameless Corporation of the Week Award

This weeks Shameless Health Care Corporation is United Healthcare. (For prior winners, scroll down the blog). I have many examples of the shameless and egregious behavior of United over the years, but this story sums up how they treat their policyholders. They treat their contracted physicians even worse.

Marlene is a single stepmom who is raising the two children of her deceased sister. They live in a cramped apartment and stretch a dollar as far as they can. She is extremely responsible about health care for herself and her stepkids. Since I don't contract with United Health Care, she pays me and sends the bill to United for them to reimburse her. Over the last two years, they have reimbursed her ZERO for health visits and illnesses for herself and the teenage kids.

Under the contract with United, they should pay a portion of "out of network" care. United has a pattern of delay and hassle that is repeated over and over. United sends me forms to fill out after each visit, even though they have the information in full on the bill I give her to submit. They want a complete duplicate of the information that they already have. When I resubmit the forms they stall and after 90 days they send a denial, stating they did not receive proper information and allowing me to "appeal" on the patient's behalf. When I send the appeal letter with copies of everything, nothing more happens. This cycle can take about a year to complete. There is no phone number to call on the letters and phone calls to United Health Care corporate puts you on a recording loop.

United Healthcare is truly a shameless corporation. Despite the fact that my patient has insurance that should cover her and her step-children, I provide heavily discounted care because I know she will never be paid a dime by United.

The CEO of United Health Group was paid $3,241,042 last year and has a retirement account of $10,703,229. The prior CEO of United was paid $342 million over 5 years. I don't know what his retirement is.

Shameless!

6 comments:

Bolina Stretta said...

< sarcasm on>
But, off course, this is not "health care rationing" right ...?
< sarcasm off>

It's terrible, just how defenseless health consumers are, and how little or no recourse we have in front of these behemoth gigantic insurance companies. I am still trying to get insurance, and it's almost useless. After reading this story, I can really go for only catastrophic insurance and be done with it.

Jo said...

Thak you, Toni, for making us aware of this! I will forward it and share it with as many people as possible. $3 mil for the CEO? Probably based on profits he's generated by denying health care to his insureds.

Cary said...

Ugh, that's my insurance and they are the worst. I joke that their claim denial codes are three digits because they have so many. Actually, though, they are better than other providers I've had (hi, Kaiser and MetLife!) but that's not saying much.

Anonymous said...

Shameful is right! Unfortunately this type of thing is actually common. My cousin worked for an "unnamed" insurer and his job was in claims follow-up. He said they were not encouraged to respond to letters or phone calls and any reason to stall or reject a claim was the culture. There were no checks and balances and no watchdog to make them comply with laws or even give basic service.

Keep telling it like it is! We need more doctors to speak out.

Moremony services said...

It's terrible, just how defenseless health consumers are, and how little or no recourse we have in front of these behemoth gigantic insurance companies. I am still trying to get insurance, and it's almost useless. After reading this story, I can really go for only catastrophic insurance and be done with it.

Attorney

Moremony

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