Editorials & Other Articles

progree

(11,389 posts) Wed Jul 24, 2024, 07:46 AM Jul 24

HealthPartners leaving UnitedHealthcare's Medicare Advantage network over high claim denial rate

HealthPartners leaving UnitedHealthcare's Medicare Advantage network over high claim denial rate, 7/23/24

HealthPartners announced Tuesday that it will no longer be part of UnitedHealthcare's Medicare Advantage network starting next year.

The nonprofit healthcare organization says it made the decision because "UnitedHealthcare delays and denies approval of payment for our patients' Medicare Advantage claims at a rate unlike any other insurer in our market." HealthParnters claims its denial rate with UnitedHealthcare has been up to 10 times higher than that of other insurers it works with.

The change applies to care provided at HealthPartners and Park Nicollet clinics and hospitals, including Methodist, Regions and Lakeview hospitals. ((These are all Twin Cities or near Twin Cities locations -Progree))

Last week, 11 people were arrested outside the UnitedHealthcare headquarters in Minnetonka for protesting what they allege is the company's practice of not paying for care.

MORE: https://www.msn.com/en-us/money/insurance/healthpartners-leaving-unitedhealthcare-s-medicare-advantage-network-over-high-claim-denial-rate/ar-BB1qwfgE

2 replies

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Highlight:

HealthPartners leaving UnitedHealthcare's Medicare Advantage network over high claim denial rate (Original Post) progree Jul 24 OP

Hospitals Leave Medicare Advantage Networks as Problems Plague Coverage - about Humana's MA plan being rejected progree Jul 24 #1

MA plans have always been a scam... justaprogressive Jul 27 #2

progree

(11,389 posts)

1. Hospitals Leave Medicare Advantage Networks as Problems Plague Coverage - about Humana's MA plan being rejected

Reply to progree (Original post)

Wed Jul 24, 2024, 11:31 PM

Jul 24

as well as the United Healthcare MA plan discussed in the OP.

Newsweek, 7/24/24

https://www.msn.com/en-us/money/insurance/hospitals-leave-medicare-advantage-networks-as-problems-plague-coverage/ar-BB1qzmah

Humana's Medicare Advantage plans will also no longer be accepted as in-network options at Aultman facilities in Ohio. ((much more about this later in the article -Progree))

... HealthPartners Blocks Medicare Advantage

((blah blah about the stuff in the OP of HealthPartners leaving UnitedHealthcare's Medicare Advantage network - Progree))

The [HealthPartners] hospital operator also previously dropped Humana's Medicare Advantage plans from its network of covered insurers.

...

For 2024, the Centers for Medicare & Medicaid Services issued a new rule increasing Medicare hospital outpatient payment system rates by 3.1 percent, but insurers have been complaining it doesn't cut their patients' needs, leading to issues with payments for the hospitals.

"The payout rate increase being argued by insurance carriers is not enough, and insurance companies are reporting higher utilization which means their members are costing them more," Chris Fong, Medicare specialist and Smile Insurance CEO, told Newsweek.

justaprogressive

(2,335 posts)

2. MA plans have always been a scam...

Reply to progree (Original post)

Sat Jul 27, 2024, 11:41 AM

Jul 27

its only purpose is a plot to destroy traditional Medicare.

Glad organizations are finally recognizing that fact.

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