Guest guest Posted April 30, 2010 Report Share Posted April 30, 2010 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 Quote Link to comment Share on other sites More sharing options...
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