A quick Monday morning nod to the wisdom of Bachman-Turner Overdrive. Having applied the wisdom of these lyrics for many years they once again proved their relevance as I read the article from Friday’s Minneapolis – St. Paul Star Tribune. The article is titled UnitedHealth billing flaws persist as company grew by David Shaffer. Below is a quick overview.
The articles first line sets the tone.
“As UnitedHealth has grown this decade into a national insurance colossus, the company has repeatedly failed a basic job: paying patients’ medical bills correctly or on time.”
UnitedHealth Group is a company on the move. They have grown to become an insurer of 70 million Americans and are watching their company profits soar to an estimated $4.7 billion this year.
While profits have soared so have lawsuits and fines against the company from all sides. One orthopedic surgeon quoted sued the giant insurer for unreimbursed claims.
“(After the) US District Judge in Missouri ruled against the insurer in November 2006 he declared its claims processing systems ‘flawed in many ways, denying, reducing and improperly processing claims on a regular basis. And despite innumberable requests, United was unwilling to remedy the underlying errors in its system.’”
“After the verdict this surgeon continued to have payment problems prompting a second lawsuit. When interviewed he stated, ‘These people can never get it right, which says to me that they just plain lie.’”
“Executives (at United) have placed the blame on rapid expansion, the complexity of medical reimbursements and difficulties in weeding out data errors that foul up claims.”
At least we all agree on the fact that medical reimbursements are complicated.
The article also shares the experience of Katie Sailors of Omaha, one of United’s customers.
“who complained to state regulators in 2004 after UnitedHealth’s computers incorrectly rejected her son’s surgery-related bill six times. ‘You automatically assume the health insurance company is doing right by you.’ “
Mandarin Cheung-Yueh of Scottsdale, AZ verified with United’s call center that the doctor and facility she made an appointment with was considered in-network. Ms. Cheung-Yueh checked her EOBs and noticed that the initial claims were processed as in-network but subsequent charges were processed as out of network. After five months of phone calls and 25 pages of documentation and a compliant to the Arizona Insurance Department, United paid the disputed amount but would not concede that its system had failed.
Despite what you are probably thinking, my purpose in sharing this is not to take a cheap shot at UnitedHealthCare or any other of the mighty insurance companies. My purpose in sharing this is to remind all of us that we have to take back complete responsibility for our own healthcare. Nobody else can or will do it for us. Nobody understands your situation as well as you do. Nobody has a larger vested interest in getting it right than you do. And nobody stands to lose more when things go awry than you do. You cannot and must not let anyone else take responsibility for your healthcare it is up to you and me to take ownership for ourselves.
So dust off that old BTO album, crank it up and sing along.
“Yes I found out all the tricks of the trade
And that there’s only one way
That you’re gonna get things done
I found out the only way to the top
Is looking out for number one
And that’s me
I’m looking out for number one”
Link to original article http://www.startribune.com/business/12279546.html