The New York Times published an article on January 15, 2009 titled UnitedHealth Settlement Near, but Faces a Potest. In the article the author, Reed Abelson, writes about how UnitedHealth has come to a settlement price of $350 millions for several class action lawsuits pending against them for not paying enough money or " reasonable and customary" rates for patients that use their coverage out of network.
The computer software that UnitedHealth had used to calculate the amount to pay toward claims and doctor reimbursement was significantly under estimating health care true market value. "Insurers typically agree to pay 70 to 80 percent of the 'reasonable and customary' local market rate for out-of-network medical services. A n investigation by Mr. Cuomo's office concluded that the database had understated the true market rates of medical care up to 28 percent.
Got a question about health insurance, ask me, the Insurance Guy, from Gizmo Health Insurance. visti www.Gizmohealth.com or call 1-312-884-5150.
Friday, January 16, 2009
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