Congressional investigators have discovered that large health insurers in every region of the country are relying on faulty databases to underpay millions of valid insurance claims. In a report released Wednesday, the Senate Commerce Committee said insurance companies nationwide have failed to provide consumers with accurate or understandable information about how they calculate ‘reasonable or ‘customary charges for out-of-network care. Insurers also signed contracts prohibiting them from disclosing information about the databases to consumers or doctors, the report said. The flawed databases are owned by Ingenix Inc., a subsidiary of UnitedHealth Group Inc. UnitedHealth recently settled with the New York attorney general’s office to resolve charges that Ingenix drew up billing rates that underpaid hospitals and doctors for out-of-network care. Patients had to make up the difference. It is unclear how much they have overpaid over the years. An Ingenix spokeswoman said the company stands by the integrity of its databases. The two databases in question by the committee represent less than 2% of Ingenix’s overall business. Ingenix also said it doesn’t set actual rates for health procedures. Other insurers that purchased Ingenix data in New York-Aetna Inc., CIGNA Corp., and Wellpoint Inc. among […]
Friday, June 26th, 2009
Big Health Firms Underpay Claims
Author: FAWN JOHNSON
Source: Wall Street Journal
Publication Date: 25-Jun-09
Link: Big Health Firms Underpay Claims
Source: Wall Street Journal
Publication Date: 25-Jun-09
Link: Big Health Firms Underpay Claims
Stephan: Reading about the illness profit industry always invokes in my mind one of those Wylie Coyote cartoons, where Coyote tries to jam something horrible into a box, only to have it ooze out around the seal as a swelling green slime. These people are like vampires whose life force is sustained by sucking the life and happiness out of the lives of others.