Blog Category:

Reduced and Denied Health Insurance Claims

11/3/2009
Carlin Phillips
Comments (0)

UCR Rate Problems: Health Insurers Covering Up Their Mistakes

Now that it is widely alleged that the Ingenix UCR rate data invalidly reduced medical provider reimbursements, what are the insurance companies that used the database to reduce medical claims doing about it?  Charged with such knowledge are they reviewing and auditing their claims payment history and paying providers back for the wrongful reductions?  You would think that when the insurer learned of such a systemic problem it would take its obligation to pay claims seriously, retrospectively audit its claims paying practices and re-pay wrongfully reduced claims.  How about notifying its insureds about how UCR rates are calculated and changing its insurance policies to disclose exactly what standard will be used to determine usual and customary charges?  I have seen audioconference advertisements targeted at insurers as "Health Plan Strategies for Minimizing Financial and Legal Risks" but I have not heard bout one insurer proactively auditing claims to pay back invalidly reduced UCR reductions.

Bookmark and Share


There are no comments.

Post a comment

Post a Comment to "UCR Rate Problems: Health Insurers Covering Up Their Mistakes"

To reply to this message, enter your reply in the box labeled "Message", hit "Post Message."

Name:*

Email:* (will not be published)

Website:

Message:

Notify me of follow-up comments via email.

For security purposes, please enter the graphic text in the box below: [hit F5 if you can not read the text]

Free Book

Contact Information

Let our legal experts review your case, and we'll help you obtain the compensation you deserve. Begin your case review by filling out the form below:

Name:

Phone:

Email:

Tell us more:


Phillips & Garcia, P.C.
13 Ventura Drive
North Dartmouth, MA 02747
Toll Free: (877) 892-5620

Get Directions

Our Address

Phillips & Garcia, P.C.
13 Ventura Drive
North Dartmouth, MA 02747
Toll Free: (877) 892-5620