Are you in network...United is having a hard time figuring this out it appears...doctors and patients since the big take over of Pacific Care in particular in California...the data all has to connect somewhere to get the claims paid..BD
The American Medical Association says no other insurer has prompted as many complaints from its physicians about unfair and abusive reimbursement practices as UnitedHealth.
38 states: UnitedHealth promises to fix its claims computers and payment systems nationwide over three years under the scrutiny of state insurance regulators. Claims-related penalties hit $18 million, including record fines in four states. Separately, California investigates complaints of claims foul-ups at PacifiCare, an insurer acquired by UnitedHealth.
UnitedHealth Group tripled in size by acquiring other companies since 2000, but insurance regulators in many states found the company often paid medical claims late or not at all -- and didn't do enough when people complained. The problems are rooted in the computers that process claims, regulators say.
Since 2000, the Minnetonka-based company, an insurer of 70 million Americans, has been sanctioned in nine states for paying claims slowly, shortchanging doctors, hospitals or patients or poorly handling their complaints and appeals, according to a Star Tribune review of regulatory records. UnitedHealth has acquired 70 companies, more than a third of them health plans, since 2000 and now insures or manages health benefits for 70 million people. Along the way, the company says it invested in the most advanced technology in the industry, part of its declared mission to improve health care.
A mess in California
In late 2005, UnitedHealth completed its $7.9 billion acquisition of PacifiCare Health Systems, based in Cypress, Calif. Within a year, California regulators noticed a spike in consumer and provider complaints and began looking into them, said Andrea Rosen, an attorney for the California Department of Insurance.