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AMA: File Claims Against UnitedHealth Now

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The American Medical Association is reminding members that it has set up a Web site to help thousands of physicians file claims against insurer UnitedHealth Group, which in January settled an AMA-filed lawsuit for $350 million.

The suit was one of at least four the AMA and several state medical societies have filed against insurers that used databases from UnitedHealth-owned Ingenix Inc. to price out-of-network claims. Suits also were filed against Aetna, Cigna and WellPoint. The suits alleged that the insurers conspired for 15 years to underpay physicians for out-of-network services.

While the deadline for filing a claim is October 5, "the AMA is urging physicians to file a claim now," a spokesperson tells Health Data Management. "This record-breaking settlement will help compensate physicians for years of artificially low payments for out-of-network services."

Physicians seeking to file a claim should ask the settlement claims administrator for a copy of the "Defendant's Report." The report indicates the covered out-of-network services and supplies provided to patients from Jan. 1, 2002, to May 28, 2010. It's a starting point, according to AMA, for the claims filing process and can save considerable time compiling necessary information.

But receiving the report can take a few weeks, necessitating the need to start now. For more information, click here.

--Joseph Goedert

 

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A major success factor for accountable care organizations will be linking caregivers across the spectrum of care delivery. If history is any indication, that's going to be an industrywide struggle.

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