Re: United Health

[Guest guest]

There is a mix-up in their system OR you need to perhaps get a separate NPI for your clinic and a new contract.  Did you sign a new contract?  You are entitled (in CA it is the law that they provide it) to a copy of your contract that you signed.  You are billing under a new entity (not the hospital).  Call provider relations and demand to move up the supervisor chain if the person you are talking to won't help. UHC has a history in certain parts of the country of being horrible to work with.  Our local PR person is wonderful and I made a teency comment about reimbursement and they automatically increased our reimbursement - no haggling whatsoever (not the case with Anthem!)

 

Good luck,

 

Good morning Everyone,Has anyone had issues with United Health? I have a new practice in RI.I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet.

I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.Now denials came. They stated I was not a provider!!!When I searched the provider list, I am no longer listed. But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.

I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

I have make more calls today..Thoughts??Debra

-- Pratt

[Guest guest]

Thanks ,

  I will try the Provider Relations department.

No they never sent me a copy of a contract. The application, etc was done all online and when I called; and I did numerous times; was told I am not a new provider so no paperwork to be sent out.

 And yes I have separate personal and practice NPI's; tax ID ..

Thanks for the assistance.

Debra

[Guest guest]

Our Two Cents for what it is worth.... If you can live without them DROP THEM and run as fast as you can. UHC does NOT Even Allow, was told point blank, for ANY Provider Calls to go directly thru to a Provider Relations Dept..... A few times and I were on both of our Lines getting bounced around from place to place and the bottom line is, It is the Official Policy to NOT Allow doctors or their Office Staff to have immediate, put thru conversations, phone calls with anyone or anything resembling a "Provider Relationship" part, dept..... We can talk to them about a claim or check on a patients membership status or their horrible paperwork trail busy work..... BUT NEVER can a doctor talk directly via a phonecall that the doctor's side innitiated by calling in. AT BEST they have a

messaging system where eventually they will Hopefully get back to you one day.....

To us that was the straw that broke the Camel's Back..... If you can't be bothered to have a direct human contact and relationship with us in a potential time of need and that we should have to sit by the phone praying that the Dominate Alpha in the relationship may at some undetermined time and date that may or may not even be convenient to us.... this totally one side in control while the other side has NO SAY in the matter what so ever, that was IT for us. And it is our Strong suggestion, advice for any and all providers to do likewise as soon as they are able..... Some contracts and some carriers are more hassle than they are worth and end up losing you more money or more productive time than they are worth.... When I can't even have a boots on the ground contact person no less a live and will answer the phone Provider Relations dept to discuss important business and patient care matters with, policy

matters, contract matters, fees, coding you name it.... Then you are HISTORY and we have never felt better in our life about dropping a carrier then we did when we dropped UHC and the NYS administered by UHC Empire Plan.... Two separate plans with two separate contracts and drops... But both of them well worth dropping because they were NOT worth working with.... They didn't even pretent to have an ounce of respect for us from day one.....

&

To: Sent: Friday, October 7, 2011 10:31 AMSubject: Re: United Health

Thanks ,

I will try the Provider Relations department.

No they never sent me a copy of a contract. The application, etc was done all online and when I called; and I did numerous times; was told I am not a new provider so no paperwork to be sent out.

And yes I have separate personal and practice NPI's; tax ID ..

Thanks for the assistance.

Debra

[Guest guest]

WOW and ,

  I can relate to your experience.

 

I can not really afford to drop them as most of the patients in my area have Blue Cross or United.  And as and NP Blue Cross will not allow me to work independently from am MD, for credentialing.  Thus stuck with United and state United ( maybe state pts pick United also in the area) 

Middle class to low income area so cash is not an option.. I would like that model

 

Thank for sharing your experience.

 

Debra

[Guest guest]

When I started my practice 3 years ago, I had the same problem with UHC. I was

trying to get a new contract to review, since I had a new PLLC and would be

billing under a new TIN from when I was employed. In spite of MANY tries, I

NEVER could get through to speak to a human being who could help me. I was in an

endless telephone tree loop that had no options appropriate to me. A couple of

times, I did something improper that got me to human being, but they always said

they could not help me and would transfer me to someone who could, whereby I

would get entered back into the endless mechanical loop! Finally, I fired off a

letter notifying them that, while I had been a participating provider when I was

with my former group, my new practice would definitely NOT be participating.

They did not respond to that, either. Best thing I ever did, since they pay

lousy, too.

Sharlene

>

> Our Two Cents for what it is worth.... If you can live without them DROP THEM

and run as fast as you can. UHC does NOT Even Allow, was told point blank, for

ANY Provider Calls to go directly thru to a Provider Relations Dept..... A few

times and I were on both of our Lines getting bounced around from place to

place and the bottom line is, It is the Official Policy to NOT Allow doctors or

their Office Staff to have immediate, put thru conversations, phone calls with

anyone or anything resembling a " Provider Relationship " part, dept..... We can

talk to them about a claim or check on a patients membership status or their

horrible paperwork trail busy work..... BUT NEVER can a doctor talk directly via

a phonecall that the doctor's side innitiated by calling in. AT BEST they have a

messaging system where eventually they will Hopefully get back to you one

day.....

>  

> To us that was the straw that broke the Camel's Back..... If you can't be

bothered to have a direct human contact and relationship with us in a potential

time of need and that we should have to sit by the phone praying that the

Dominate Alpha in the relationship may at some undetermined time and date that

may or may not even be convenient to us.... this totally one side in control

while the other side has NO SAY in the matter what so ever, that was IT for us.

And it is our Strong suggestion, advice for any and all providers to do likewise

as soon as they are able..... Some contracts and some carriers are more hassle

than they are worth and end up losing you more money or more productive time

than they are worth.... When I can't even have a boots on the ground contact

person no less a live and will answer the phone Provider Relations dept to

discuss important business and patient care matters with, policy matters,

contract matters, fees, coding you name

> it.... Then you are HISTORY and we have never felt better in our life about

dropping a carrier then we did when we dropped UHC and the NYS administered by

UHC Empire Plan.... Two separate plans with two separate contracts and drops...

But both of them well worth dropping because they were NOT worth working

with.... They didn't even pretent to have an ounce of respect for us from day

one.....

>  

> &

>

>

> ________________________________

>

> To:

> Sent: Friday, October 7, 2011 10:31 AM

> Subject: Re: United Health

>

>

>  

> Thanks ,

>   I will try the Provider Relations department.

> No they never sent me a copy of a contract. The application, etc was done

all online and when I called; and I did numerous times; was told I am not a new

provider so no paperwork to be sent out.

>  And yes I have separate personal and practice NPI's; tax ID ..

> Thanks for the assistance.

> Debra

>

[Guest guest]

Sharlene,

  Thanks for sharing your experience.

Unfortunately I have already seen  many UH patients.

Update:I did speak with 2 humans today at UH; my credentials are up to date, no issues.  Looks like demographics and/or contract management never linked my id/name and tax id... Hopefully with the faxes I sent I will have it straighten out soon...

But I won't hold my breath.

I will keep you posted.

Thanks

[Guest guest]

Drop them while you still can. Nothing will get better, only worse, and when I did have them, they re-imbursed for vaccines, and the injection fee, less than the actual vaccine cost me. No answers, screwed up paperwork constantly, no one who knew or would do anything. They even screwed up me dropping them, continuing to send patients by having me listed as a provider on their website, months after I dropped them.

Cote' MD

To: Sent: Friday, October 7, 2011 8:43:30 AMSubject: United Health

Good morning Everyone,Has anyone had issues with United Health? I have a new practice in RI.I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet.I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.Now denials came. They stated I was not a provider!!!When I searched the provider list, I am no longer listed. But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!I have make more calls today..Thoughts??Debra

[Guest guest]

As others have said, RUN!  They do pay terribly, if they pay at all.  In 1999 I was hired to start at a private practice when I finished residency in 7/2000.  My new employer started working to get me credentialed with UHC in 11/99.  By the time I left that group, in 7/2002, UHC had NEVER paid a penny for all the work I did for their members in 2 years.   I think it added up to over $50K, and althought they contacted me about 2 months AFTER I left that group to say " Congratulations, you are now a UHC provider " , they never went back and paid what they owed.

 

As you can guess, I never credentialled with them while I was in my IMP practice.  Now that I am a hospital employee, I am a provider for them, but they still don't pay.  And the really sick thing is that our hospital has its insurance for employees with them....I almost didn't accept it..

 

Annie

 

Good morning Everyone,Has anyone had issues with United Health? I have a new practice in RI.I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet.

I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.Now denials came. They stated I was not a provider!!!When I searched the provider list, I am no longer listed. But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.

I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

I have make more calls today..Thoughts??Debra

-- Annie Skaggssville, KY

[Guest guest]

Why would anyone take united healthcare, or any other managed care?

Look at the numbers.

Let's say their contract reimburses you $55 for a 99213. With the average copay

of $30, that leaves you with maintaining a billing apparatus to collect $25. And

most of the time they screw up on purpose knowing the time to fight them is not

worth your time.

If $55 is enough for a visit, charge that to your patients directly, or develop

your own fair and reasonable fee schedule or yearly fee.

Horvitz, D.O.

Founder of the Institute for Medical Wellness

stown, NJ

>

>

>

> Drop them while you still can.  Nothing will get better, only worse, and when

I did have them, they re-imbursed for vaccines, and the injection fee, less than

the actual vaccine cost me.  No answers, screwed up paperwork constantly, no

one who knew or would do anything.  They even screwed up me dropping them,

continuing to send patients by having me listed as a provider on their website,

months after I dropped them.

>

> Cote' MD

>

>

>

> United Health

>

>  

>

>

>

>

> Good morning Everyone,

>

> Has anyone had issues with United Health? I have a new practice in RI.

> I applied and was credentialed; no packet was sent only a number was assigned;

as I also still work P/T as a hospitalist; so was told I am not a new provider

thus no packet.

>

> I received three seperate checks for 5 DOS to 3 patients over the last 2

weeks.

>

> Now denials came. They stated I was not a provider!!!

>

> When I searched the provider list, I am no longer listed.

> But from the provider web access both ( the hospitalist and office) numbers

are still their to allow submission of claims.

>

> I am getting the run around, and so was the gentleman who is helping me with

billing. Credentialing sent us to another department as said I wasn't listed as

a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

>

> I have make more calls today..

>

> Thoughts??

>

> Debra

>

[Guest guest]

RE payments from insurers

Sadly depends on the contract.

Had a family ask me to sign up with United Healthcare -- actually pays me equal to best payors in area.

Can't tell you what as each contract is specific and the contract prohibits saying amounts.

This is NOT always true -- Devon offered me 60% of Medicare, I told them to take a hike.

Matt in Western PA

United Health > > Â > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI. > I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks. > > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims. > > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!! > > I have make more calls today.. > > Thoughts?? > > Debra>

[Guest guest]

Matt,

What is the approximate % of your zone Medicare within 5-10 %??? Hint, Hint..... :-)

To: Sent: Saturday, October 8, 2011 8:02 PMSubject: Re: Re: United Health

RE payments from insurers

Sadly depends on the contract.

Had a family ask me to sign up with United Healthcare -- actually pays me equal to best payors in area.

Can't tell you what as each contract is specific and the contract prohibits saying amounts.

This is NOT always true -- Devon offered me 60% of Medicare, I told them to take a hike.

Matt in Western PA

United Health > > Â > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new

practice in RI. > I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks. > > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims. > > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!! > > I have make more calls today.. > > Thoughts?? > >

Debra>

[Guest guest]

Thank you everyone for all your thoughts and experiences with United.

 

I would love to just take cash, but most of the people in my area are working poor.  May have " rite share " united a medicaid the pay partially into and also medicaid United.

The lower charge for an office visit (ie $55) might work as I have a lower overhead... I will give it some thought.

 

Thanks again,

Debra

 

Matt,

    What is the approximate % of your zone Medicare within 5-10 %??? Hint, Hint..... :-)

 

To: Sent: Saturday, October 8, 2011 8:02 PM

Subject: Re: Re: United Health

 

RE payments from insurers

 

Sadly depends on the contract.

 

Had a family ask me to sign up with United Healthcare -- actually pays me equal to best payors in area.

Can't tell you what as each contract is specific and the contract prohibits saying amounts.

This is NOT always true -- Devon offered me 60% of Medicare, I told them to take a hike.

 

Matt in Western PA

 

United Health > >   > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI.

> I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.

> > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.

> > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

> > I have make more calls today.. > > Thoughts?? > > Debra>

[Guest guest]

Deb,

Here's something that I think some of you newbies don't understand though and forgive me if I am repeating something that you do know... Sometimes as much as we would all Love to Run Away from these bozos as you just pointed out we really can't. BUT, there is more to this in gray areas that yes or no, black and white, on or off. Let's say that United is Starving you out, or some other payer who pays somewhat better but is a HUGE PITA with tons of paperwork, unpaided, delayed claims, getting claims cleared costs more time or money that they are worth.... Sometimes dropping those kinds of carriers ALL while staying PAR with others who are better to deal with or pay you better, hopefully BOTH, might make more sense. For really small practices like ours where we don't carry super large panels of 2-3,000 patients, usually most of us are at or much

below that, 250 to 1,000 on average as an educated guess, it does not take a lot of patients and carriers to make or break you... Nor does it take a lot of patients to replace those that you lose from dropping one or two of your "Worst" carriers....

All practices should review their panel of carriers, patients, claims, Paperwork BS, to see if there are some worth dropping. So if you drop 150 patients (and some may stay on anyway according to many differing factors) whose insurance is under paying you by $20 bucks a claim and you start working out the numbers even at only one claim per patient that is $3,000 dollars, two or three times that amount of visits and claims and it can really start to ballon. That is real money for small guys like us.... If you can get a majority of your patients from your best paying carriers by dropping and replacing as time goes on, that is working smarter not harder.... Now you get paid more for the same amount of works, patient visits.... This is why we dropped those two UHC related products because they were so hard to deal

with AND they were some of our worst payors. People here in our town NOW know that their State Employee Empire Plan SUCKS and that it is really hard to find any doctor who is willing to take any or any more new patients with it. So in that case we lost probably less than 50% of them. And of those that we lost, they were the more difficult, self entitled NY attitude ones that we were only too glad to see them go. One Mom and her family in particular comes to mind.... So in that case we replaced 50% with better paying plans and the other 50% stayed on and now pay us in full at time of service and that is a good fair price and cash right then and there on barrel with no insurance hassles and no charges from our billing company either...

So try to re-examine your situation and think about opening up room on your panel for better paying patients whose plans are not as much of a hassle or pain in the butt... So you are not leaving the system immediately if ever but at least you are attempting to play its rules to your own advantage as best as possible. We are not some super large, sightless, mindless, deaf and blind group that wants to devour an entire area and takes all comers with all plans putting their docs on hamster wheels. Instead we can pick and choose which plans if at all we care to PAR with, and in many cases that is compromise we can live with at least for some amount of time... We starting doing that a few years ago, got distracted and now we need to start looking at getting out completely because

we just can't play this game anymore... The rules and hops are just too much now....

To: Sent: Sunday, October 9, 2011 9:15 AMSubject: Re: Re: United Health

Thank you everyone for all your thoughts and experiences with United.

I would love to just take cash, but most of the people in my area are working poor. May have "rite share" united a medicaid the pay partially into and also medicaid United.

The lower charge for an office visit (ie $55) might work as I have a lower overhead... I will give it some thought.

Thanks again,

Debra

Matt,

What is the approximate % of your zone Medicare within 5-10 %??? Hint, Hint..... :-)

To: Sent: Saturday, October 8, 2011 8:02 PMSubject: Re: Re: United Health

RE payments from insurers

Sadly depends on the contract.

Had a family ask me to sign up with United Healthcare -- actually pays me equal to best payors in area.

Can't tell you what as each contract is specific and the contract prohibits saying amounts.

This is NOT always true -- Devon offered me 60% of Medicare, I told them to take a hike.

Matt in Western PA

United Health > > Â > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new

practice in RI. > I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks. > > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims. > > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!! > > I have make more calls today.. > > Thoughts?? > >

Debra>

[Guest guest]



Straight Medicare about 10% or less.

75% of people on Medicare have a "Medicare Advantage" plan in general in the area.

United Health > > Â > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI. > I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks. > > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims. > > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!! > > I have make more calls today.. > > Thoughts?? > > Debra>

[Guest guest]



Yup ...

United paying reasonably well my area as they want to penetrate, got more pts, I know that is curious but it's because United is willing to pay me more than it pays you to put me "on a list."

Now Medicaid/DPA -- $23/visit that is ANOTHER story, I just can't afford to take them, and send them on to the hospital clinics, dual eligible too.

Matt

United Health > > Â > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI. > I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks. > > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims. > > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!! > > I have make more calls today.. > > Thoughts?? > > Debra>

[Guest guest]

The majority of my patients; and people in the are; have United, medcare, medicaid..

So I'm stuck with these trouble I think...

I do have a handful of non insured who pay cash.

 

 Yup ...

 

United paying reasonably well my area as they want to penetrate, got more pts, I know that is curious but it's because United is willing to pay me more than it pays you to put me " on a list. "

 

Now Medicaid/DPA -- $23/visit that is ANOTHER story, I just can't afford to take them, and send them on to the hospital clinics, dual eligible too.

 

Matt

United Health > >   > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI.

> I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.

> > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.

> > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

> > I have make more calls today.. > > Thoughts?? > > Debra>

[Guest guest]

If others in your area are not taking UHC, then taking them could definately be a compeitive advantage in the marketplace. Seeing patients is always better than an empty slot. We have no moer issues with them

than other insurers, and infact they pay us electronically very quickly. We also get about the same rates, that runs somewhere about 165% MDC.

From: [ ] On Behalf Of Debra Karinski [dkarinskinp@...]

Sent: Sunday, October 09, 2011 7:15 AM

To:

Subject: Re: Re: United Health

Thank you everyone for all your thoughts and experiences with United.

I would love to just take cash, but most of the people in my area are working poor. May have " rite share " united a medicaid the pay partially into and also medicaid United.

The lower charge for an office visit (ie $55) might work as I have a lower overhead... I will give it some thought.

Thanks again,

Debra

On Sat, Oct 8, 2011 at 10:30 PM, Bleiweiss

wrote:

Matt,

What is the approximate % of your zone Medicare within 5-10 %??? Hint, Hint..... :-)

To:

Sent: Saturday, October 8, 2011 8:02 PM

Subject: Re: Re: United Health

RE payments from insurers

Sadly depends on the contract.

Had a family ask me to sign up with United Healthcare -- actually pays me equal to best payors in area.

Can't tell you what as each contract is specific and the contract prohibits saying amounts.

This is NOT always true -- Devon offered me 60% of Medicare, I told them to take a hike.

Matt in Western PA

United Health

>

> Â

>

>

>

>

> Good morning Everyone,

>

> Has anyone had issues with United Health? I have a new practice in RI.

> I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet.

>

> I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.

>

> Now denials came. They stated I was not a provider!!!

>

> When I searched the provider list, I am no longer listed.

> But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.

>

> I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

>

> I have make more calls today..

>

> Thoughts??

>

> Debra

>

[Guest guest]

Thank you for sharing. 165% of Medicare? $59 Flu shot? I billed the Q and G code for flu shot as Medicare required this year. Around $37 here is Northern CA. Almost never billed 99215 yet, even though spending one hour with Diabetic. Worried about Auditing.

CO is so primary care friendly!

 

Wen Liang

San Mateo, CA

 

 

If others in your area are not taking UHC, then taking them could definately be a compeitive advantage in the marketplace. Seeing patients is always better than an empty slot. We have no moer issues with them

than other insurers, and infact they pay us electronically very quickly. We also  get about the same rates, that runs somewhere about 165% MDC.

From: [ ] On Behalf Of Debra Karinski [dkarinskinp@...]

Sent: Sunday, October 09, 2011 7:15 AMTo: Subject: Re: Re: United Health

 

Thank you everyone for all your thoughts and experiences with United.

 

I would love to just take cash, but most of the people in my area are working poor.  May have " rite share " united a medicaid the pay partially into and also medicaid United.

The lower charge for an office visit (ie $55) might work as I have a lower overhead... I will give it some thought.

 

Thanks again,

Debra

 

Matt,

    What is the approximate % of your zone Medicare within 5-10 %??? Hint, Hint..... :-)

 

To: Sent: Saturday, October 8, 2011 8:02 PM

Subject: Re: Re: United Health

 

RE payments from insurers

 

Sadly depends on the contract.

 

Had a family ask me to sign up with United Healthcare -- actually pays me equal to best payors in area.

Can't tell you what as each contract is specific and the contract prohibits saying amounts.

This is NOT always true -- Devon offered me 60% of Medicare, I told them to take a hike.

 

Matt in Western PA

 

United Health > >   > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI.

> I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks.

> > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims.

> > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!!

> > I have make more calls today.. > > Thoughts?? > > Debra>

[Guest guest]

RE is seeing pts ALWAYS a competitive advantage.

I would caution you NOT to discount your services as "seeing pts is [NOT] always a competitive advantage" if pts are inappropriate or high maintenance OR high no shows as many of the Medicaid pts in our area are....

Not all but many...I stopped this group after 3 years in to independent practice, just NOT worth the hastle, and the pay in my area for Medicaid is $23/visit.

Matt in Western PA

United Health > > Â > > > > > Good morning Everyone, > > Has anyone had issues with United Health? I have a new practice in RI. > I applied and was credentialed; no packet was sent only a number was assigned; as I also still work P/T as a hospitalist; so was told I am not a new provider thus no packet. > > I received three seperate checks for 5 DOS to 3 patients over the last 2 weeks. > > Now denials came. They stated I was not a provider!!! > > When I searched the provider list, I am no longer listed. > But from the provider web access both ( the hospitalist and office) numbers are still their to allow submission of claims. > > I am getting the run around, and so was the gentleman who is helping me with billing. Credentialing sent us to another department as said I wasn't listed as a provider!!!!. I have been a credentialed hospitalist provider since 1996!! > > I have make more calls today.. > > Thoughts?? > > Debra>