RE: United HC Class Action - NOTICE OF PROPOSED SETTLEMENT OF CLASSACTIONAND FINAL SETTLEMENT HEARING

[Guest guest]

We’ve gotten 3 notices. I don’t

think we qualify; I interpreted to be for OON services only. We are not

out of network.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of Locke, MD

Sent: Friday, April 30, 2010 7:08

AM

To: ;

practicemgt@...

Subject:

United HC Class Action - NOTICE OF PROPOSED SETTLEMENT OF CLASSACTIONAND FINAL

SETTLEMENT HEARING

Anyone submitting

the paperwork for this?

Not clear to me

that it is worth the effort or not.

Seems too involved

for a solo doc to # crunch and pull claims.

===================================

Important

information. In order to assist Subscribers and Providers in

filing their Group B, C or D claims, Defendants will make available

to the Claims

Administrator certain claims information, including the dates that Covered OON

Services or Supplies were either received or

provided and the

Allowed Amounts, from January 1, 2002 through May 28, 2010. You may request

such information and use it to complete your

claim form (see page 8, paragraph 4).You must provide

information concerning Covered OON Services or Supplies prior to January 1,

2002, and

after May 28, 2010

from other sources, and use this information to complete your claim form.

Option

for Providers

Group

D — Provider Claims for Adjusted Bill Amounts. You are

eligible to participate as a Group D claimant only

if:

• You

received an assignment from a Subscriber; and

• You

submitted a claim for reimbursement to a Defendant for Covered OON Services or

Supplies based on the assignment and the claim was

processed or

reimbursed by a Defendant using an Ingenix Database or one of the Seven OON

Reimbursement Policies; and

• You sent

an Adjusted Bill to a Subscriber (except as provided below); and

• The

Subscriber did not pay the full amount of your Adjusted Bill (except as

provided below).

The Recognized Loss for a Provider is 90% of the

Adjusted Bill amount the Subscriber did not pay you, provided, however, that you

submitted the Adjusted Bill to a collection agency,

reported it to a credit agency, or entered into a payment plan with the

Subscriber. We will

subtract from this amount 20% per claim, up to a

total of $2,000 over all of your claims, to take into account the co-payments,

co-insurance, or

deductibles the Subscriber would ordinarily owe

under the Subscriber’s healthcare plan.

If during the Settlement Class Period you did not

submit the Adjusted Bill to a collection agency, reported it to a credit

agency, or if you did

not enter into a payment plan with the Subscriber,

your Recognized Loss is 70% of the Adjusted Bill amount the Subscriber did not

pay you,

provided however, that you sent the Adjusted Bill

on or after January 1, 2002.

If you did not send an Adjusted Bill to a

Subscriber at all, or if you did but it does not satisfy the requirements in

the above two paragraphs, your

Recognized Loss is 50% of the difference between

what you billed a Defendant and the amount the Defendant and/or the Subscriber

paid you.

We will subtract from each of these amounts 20% per

claim, up to a total of $2,000 over all of your claims, to take into account

the copayments,

co-insurance, or deductibles the Subscriber would

ordinarily owe under the Subscriber’s healthcare plan.

When you receive a

payment from the Net Settlement Fund you will be deemed to have released the

Subscriber from further liability relating

to the specific

claim you make. When you and the Subscriber submit the same claim, as the

assignee you will receive the payment.

===================================

http://www.uniteducrsettlement.com/

Welcome to the UnitedUCRSettlement.com

website

On November 17, 2009, the Court entered a Memorandum and Order

preliminarily approving a $350,000,000 class action settlement with

UnitedHealth Group, resolving a nearly decades-long challenge to its practices

involving reimbursement for health care services by out-of-network providers.

On January 4, 2010, the Court entered an Order setting down certain dates

important to potential class members. Those dates were changed by Order dated

February 25, 2010.

Notice to potential class members will be mailed no later than May 28, 2010.

The Notice will include all relevant instructions regarding how to file a Proof

of Claim (along with the form itself), how to object to the settlement and how

to opt-out of the settlement. A final fairness hearing is scheduled for

September 13, 2010.

Listed below are documents relating to the Settlement. Click on the document to

access the PDF version.

Deadlines include:

Deadline for Requesting Exclusion from the Class (“Opting Out”)

– July 27, 2010

Deadline for Objections – July 27, 2010

Proof of Claim Due Date – October 5, 2010

For questions about your Proof of Claim,

please contact:

Berdon Claims Administration LLC

Listed below are documents relating to the Settlement. Click on the

document to access.

Documents related to filing a Proof of

Claim

Mailed Notice

+ Proof of Claim Form

=============================================

http://www.uniteducrsettlement.com/pdf/UHC%20Notice%20%20Claim%20Form-Final.pdf

NOTICE OF PROPOSED SETTLEMENT OF CLASSACTIONAND FINAL

SETTLEMENT HEARING

A CLASS ACTION SETTLEMENT INVOLVING UNITED HEALTHCARE

CORPORATION (NOW KNOWN AS

UNITEDHEALTH GROUP), AND ITS SUBSIDIARIES AND AFFILIATES WILL

PROVIDE CASH PAYMENTS TO

PERSONSWHO RECEIVED OR FURNISHED OUT-OF-NETWORK HEALTHCARE

SERVICES ANDWHO QUALIFY

YOUR LEGAL RIGHTS ARE AFFECTED WHETHER OR NOT YOU ACT

PLEASE READ THIS NOTICE CAREFULLY

A court authorized this Notice. This is not a solicitation

from a lawyer.

•

If you were or are:

(1) a Subscriber, which means a member of a

healthcare plan insured or administered by a Defendant, and received Covered

Out-of-Network (“OON”) healthcare benefits at any time from March

15, 1994 through November 18, 2009 that were processed or reimbursed by a

Defendant using the Ingenix Databases or one of the Seven OON Reimbursement

Policies; or

(2) a Provider or Provider Group, which means a healthcare Provider or

healthcare Provider Group who furnished Covered OON Services or Supplies to a

Subscriber at any time from March 15, 1994 through November 18, 2009 and whose

claim for payment was processed or reimbursed by a Defendant using the Ingenix

Databases or one of the Seven OON Reimbursement Policies, you are a member of

the Settlement Class and may be eligible for a payment if you qualify and

submit a valid Claim Form.

• Defendants

are United HealthCare Corporation (now known as UnitedHealth Group), Ingenix,

Inc., Metropolitan Life Insurance Company, American Airlines, Inc., and their

subsidiaries and affiliates. Please note the following non-exhaustive list of

subsidiaries and affiliates of United HealthCare Corporation or UnitedHealth

Group:

Oxford Health Plans, Inc. MAMSI

Sierra Health Services, Inc. Fidelity Insurance Group

PacifiCare Health Systems, Inc. Touchpoint Health Plan, Inc.

Mid-Atlantic Medical Services, Inc. Neighborhood Health

Partnership, Inc.

Golden Rule Insurance Company Definity Health Corp.

HealthWise Deere Health Care, Inc.

HealthPartners of Arizona, Inc. IBA Health & Life

Assurance Co. and

PHP, Inc. IBA Self-Funded Group, Inc.

MetraHealth Arnett Health Plans, Inc.

GenCare Health Systems, Inc. HCT

Student Resources (former student insurance United Medical

Resources, Inc.

division of MEGA Life and Health Insurance Co.) (UMR)

Fiserv, Inc.

•

The Seven OON Reimbursement Policies are Defendants’ (1) Anesthesia

Policy, (2) Assistant Surgeon Policy, (3) Co-Surgeon/Team Surgeon Policy, (4)

Multiple Procedure Policy, (5) Preventative Medicine Policy, (6) Professional/Technical

Policy, and (7) Reduced Services Policy.

•

The Ingenix Databases are the Prevailing Healthcare Charges System

(“PHCS”) database and the MDR Payment System database.

•

An in-patient or out-patient hospital or facility is a Provider Group if and only to the extent that it bills

for Covered OON Services or Supplies delivered by a Provider.

•

If you have a question whether you were insured by United HealthCare,

UnitedHealth Group, or a subsidiary or affiliate thereof, please contact the

Claims Administrator, as detailed in Section XIV, below.

Locke, MD