Hi All,
As if to accent the discussion we had a few days ago, about the role that insurance companies play in our health care, the Today Show aired a story this morning, about Oxford Insurance, and their parent company, UnitedHealth Group, who have apparently agreed to pay $50 million in a settlement, after the New York attorney general's office investigated claims that they were defrauding customers, by under-reimbursing them.
This may prove to be the tip of the iceberg, according to the NY attorney general, and he suggests that many other insurance companies may be doing the same thing. Apparently, other insurers, (such as Aetna, CIGNA and WellPoint/Empire BlueCross BlueShield, for example), use the same rating agency, Ingenix, though Oxford Insurance is the only company that has been investigated, at this point.
If you missed the story on the news this morning, here's the coverage on the Today Show's web site.
http://today.msnbc.msn.com/id/28635329/
If you have insurance with this company, you may be due a reimbursement out of this settlement.
Needless to say, I still don't believe that insurance companies are in business to help anyone, other than themselves. Too many of them appear to be first, last, and always, Greedy, with a capitol "G".
Tex
Another Insurance Scam In The News :roll:
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Another Insurance Scam In The News :roll:
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
- kate_ce1995
- Rockhopper Penguin

- Posts: 1321
- Joined: Wed May 25, 2005 5:53 pm
- Location: Vermont
Hmm...might explain why I have to fight with the insurance every time I go to the doctor because even though my co-pay clearly says on the card (and in all other documentation) that it's $25/visit, the payment to the dr. always says I owe $40. I've called 3 times, gotten each one corrected, and then my last statement came through the same way! So aggrivating.
Plus my husband's company just went to a high deductable EPO plan, but his company is paying part of the detuctible (it's very confusing) so the paper work tripled...he goes to the dr, dr. sends him a bill, he submits bill to insurance, they cover whatever, send it back, his company sends to the company managing the deductible fund, they send him a check, he pays the dr. Can't wait to figure this out for real!
Katy
Plus my husband's company just went to a high deductable EPO plan, but his company is paying part of the detuctible (it's very confusing) so the paper work tripled...he goes to the dr, dr. sends him a bill, he submits bill to insurance, they cover whatever, send it back, his company sends to the company managing the deductible fund, they send him a check, he pays the dr. Can't wait to figure this out for real!
Katy
Katy,
Isn't that ridiculous, considering the sophisticated state of computerized billing, these days. It just proves that the system is biased toward ripping off any patient who doesn't stay on her/his toes, or anyone who is unsure, or who gets tired of complaining. I'm sure they make a lot of easy money that way, in the long run.
Looking at the convoluted routine required of any claim filed in your husband's plan, it's pretty clear that if any claim clears all those hurdles without any mistakes along the way, it would almost be a miracle, wouldn't it? By requiring a process so complicated that everyone concerned stays confused, the insurance companies tilt the odds in their favor, so that it's easy for them to rip off virtually anyone.
Obviously, insurance companies must be huge campaign fund contributors, and they must hire some of the best lobbyists in the business, or it would seem that congress would put a stop to all that foolishness, by requiring them to use simplified and straightforward accounting practices, that anyone could deal with.
Tex
Isn't that ridiculous, considering the sophisticated state of computerized billing, these days. It just proves that the system is biased toward ripping off any patient who doesn't stay on her/his toes, or anyone who is unsure, or who gets tired of complaining. I'm sure they make a lot of easy money that way, in the long run.
Looking at the convoluted routine required of any claim filed in your husband's plan, it's pretty clear that if any claim clears all those hurdles without any mistakes along the way, it would almost be a miracle, wouldn't it? By requiring a process so complicated that everyone concerned stays confused, the insurance companies tilt the odds in their favor, so that it's easy for them to rip off virtually anyone.
Obviously, insurance companies must be huge campaign fund contributors, and they must hire some of the best lobbyists in the business, or it would seem that congress would put a stop to all that foolishness, by requiring them to use simplified and straightforward accounting practices, that anyone could deal with.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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annie oakley
- King Penguin

- Posts: 3859
- Joined: Fri May 13, 2011 5:56 pm

Visit the Microscopic Colitis Foundation Website

