[lbo-talk] New AMA report says Medicare out-performs most private insurers

John Thornton jthorn65 at sbcglobal.net
Tue Jun 17 15:21:54 PDT 2008


B. wrote:
> Some health insurance companies rate doctors on their
> performance. Now doctors are turning the tables.
>
> The American Medical Association issued its first
> health insurance report card at the group's annual
> meeting Monday. The primary focus is on how quickly
> and accurately doctors get paid.
>
> [...]
>
> UnitedHealthcare had the lowest rate of contract
> compliance, according to the AMA report. About 62
> percent of medical services billed were paid by
> UnitedHealthcare at the contracted rate, compared with
> 71 percent for Aetna and 98 percent for Medicare.
>
> UnitedHealthcare spokesman Gregory Thompson said
> doctors and their billing services share
> responsibility for prompt payment.

This is almost funny. I have UnitedHealthCare and they are awful. They actually tell you it is your responsibility to make sure everything done is done "in system" by preferred or accepted providers. Recently my wife had some lab specimens sent to an "out of system" lab so United refused to pay for it even though he doctor is "in system". That labs status had just changed about two weeks prior when it had been "in system". She had called to confirm this because this has happen in the past. United told her it was her responsibility to find out what lab her doctor used and if it was not "in system" she should personally take it to an the nearest "in system" lab, which in this case was ~300 miles away. I asked their billing department if they really believed that a doctor would give lab specimens to patients or if any lab would accept specimens brought in off the street by patients who lived 300 miles away and he told me that he doubted they would but that was the patients problem, not United's. When told she had called to confirm and was told the lab was an accepted provider only to be told later that it was not his reply was even more insane. He claimed it is the patients responsibility to find out, not United's to provide the correct answer. When asked how one could find out other than calling United he said calling United was your best bet but was no guarantee or an correct answer. I'm not sure where they find people capable of repeating such nonsense while maintaining a professional demeanor. The whole thing is so surreal during a conversation I can't keep from laughing over the absurdity of it. No argument in the world will ever get them to change their mind no matter how ridiculous are their policies. Of course those policies are about saving the company money and nothing else. Certainly they are not about providing good care. I'd much rather deal with a Government bureaucrat than a corporate bureaucrat in most instances.

John Thornton



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