UnitedHealthcare and its Georgia unit face a proposed fine of $2.4 million -- a record penalty for a health insurer in the state -- for not promptly paying doctors and hospitals, state Insurance Commissioner John Oxendine said Monday. Oxendine said his Insurance Department staff recommended the penalty, and that he will hold a hearing Oct. 31 to rule on the matter.
Up to 80,000 claims by doctors and hospitals were not paid in a timely manner, he said. Georgia's "prompt pay" law states that insurers must pay a medical provider's claim within 15 working days, or explain why there is a delay.
United called the fine "a disproportionately high penalty" and said it disputed the Insurance Department's calculations. "We're literally baffled by the commissioner's approach," said Roger Rollman, a spokesman for Minnesota-based United.
"UnitedHealthcare of Georgia is a first-class operation," he said. "We think it's very odd that only UnitedHealthcare is being cited. ... We will respond forcefully to this."
United has more than 500,000 Georgians in its private health insurance plans.
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[From a story on page D1, the Business Section, Atlanta Journal-Constitution, October 11, 2005]
From my own experience, when United Health Care was paying medical bills for my late wife, UHC routinely required more documentation (thus delaying payment) and used other tactics to put off paying the bill. It happened so often that it had to be a pattern.
ReplyDeleteNow, of course, KR & UHC have gone together to all but eliminate payments for those on Medicare, with the dance of saying that Medicare determines the amount that UHC would pay, then not paying what Medicare doesn't, leaving it to BJ retirees to soak up the difference.
On top of that, of course, KR/UHC dropped fee-for-service, which I have had since I began work at the BJ, and which my Guild contract said would remain throughout my retirement life, and implemented a system which adds significantly to my out-of-pocket costs.
Another yacht for Tony Ridder.