Health Insurers Suck

Got a funny story from a doctor today about health insurers, this one being apart of
UnitedHealth Group in particular.

The Doctor says he's the insurance coordinator/admin for his office and a year ago he switches insurance providers starting July 1 for his office. On July 15th his wife goes to get a prescription filled and the pharmacy asks for her new insurance card and she provides it. About 45 days later, the doctor gets a call from a "collecting agency" and says you owe the PREVIOUS/OLD insurance company $245 or we will pursue with legal procedings, the doctor says "let me explain" and they say "we don't take explanations" and they hang up.

The doctor then writes a letter to the old insurance company and also to Georgia's insurance commissioner explaining he's not at fault, the pharmacy billed the wrong insurer. The commissioner replies back saying the doctor/individual should take care of it and write back if it's not handled.

So the doctor contacts the pharmacy and asks for them to do something and they say they can't do anything with the insurers after 30 days.

The doctor tries again with the insurance company and they say something along the lines of "you need to contact your company's insurance coordinator, here's a 30 page copy of the contract with the applicapble terms and conditions....pay up." Keep in mind, all during this, the doctor hears multiple, multiple similar stories in his office and with other people.

The doctor goes, "they just made a big mistake, I'm the insurance coordinator, and here's a copy of the REAL contract without those terms and conditions." So the doctor writes a letter back to the insurance company and insurance commissioner saying those things, threatens legal action, gives a bill to the insurance company demanding them to reimburse his time dealing with this and to fix his credit history with the collection issue.

In the end, the insurance company sends an apology to the doctor and they get a "slap on the wrist" from the insurance commissioner. Lastly, the insurance company says the "collecting agency" is not really a collecting agency but "just in name only." What a mess, the doctor didn't get reimbursed but he told me this episode of events to encourage COMPLAINING to the insurance companies, HR people who pick the insurance providers, insurance overseers, etc.

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From Wiki, some complaints about UnitedHealth Group :
In a recent non-insurance industry survey of health care executives who have dealt with the company, UnitedHealth Group received a 91% unfavorable rating - the worst ranking among all listed.[2]

In June 2006, the American Chiropractic Association filed a national class action lawsuit against the American Chiropractic Network (ACN), which is owned by United Healthcare (which is owned by UnitedHealth Group) and administers chiropractic benefits, and against United Healthcare itself, for alleged practices in violation of the federal RICO act (racketeering).

In February 2008, New York State Attorney General Andrew M. Cuomo announced that he was conducting an industry-wide investigation into a scheme by health insurers to defraud consumers by manipulating reimbursement rates. The announcement included a statement that Cuomo intended "to file suit against Ingenix, Inc, its parent UnitedHealth Group and three additional subsidiaries."