Skip to Content

Is United penny-pinching pediatricians?!

Per a September 3 article in Modern Healthcare, United is accused of shortchanging pediatricians who are just trying to do due diligence against COVID-19.

UnitedHealthcare is known for denying coverage. Old story, we know. But now, they’ve targeted pediatricians.

Seems a little aggressive, right? The American Academy of Pediatrics (AAP) seems to agree, and they aren’t staying quiet about it.

According to an article in Modern Healthcare, pediatricians across the country are claiming United is shortchanging them. Pediatricians are calling out the industry giant, saying United is only paying about 50% of the federal rate for vaccine administration and below-market rates for COVID-19 tests.

The worry is that with these low fees, many providers might stop offering these services. Horrible timing, United, considering we’re surging with the new Delta variant—particularly in children. The week of August 19th, young people accounted for 180,000 cases of COVID-19 in the U.S. Another way to put it: children’s cases make up about 18 percent of newly reported cases.

While no insurer is legally required to pay the federal rate, wouldn’t they want what’s best for the public health?

And what about COVID-19 testing, you ask? Yep, AAP reports lower than market rates for those, too.

So, round and round and round we go. We know we’re a broken record when it comes to United and their antics, but it bears repeating:

  • Providers nationwide saw massive hits to their volume and financial stability due to the pandemic.
  • Payor claims tanked as a result, and profits soared.
  • Vaccines and COVID-19 tests are key to stopping the pandemic.
  • United, with a market capitalization over $400 billion, seems to be penny-pinching pediatricians.

Look, Dr. Peter Pogacar, VP of the Rhode Island chapter of the AAP and a pediatrician at East Greenwich Pediatrics, puts it better than we ever could in an interview with Modern Healthcare:

“Among pediatric circles, UnitedHealthcare is often referred to as the ‘evil empire’ since they are the least transparent and least cooperative among the major insurers.”

Enough said.

Original Article:

Subscribe to Un-covered Essentials

Your payor relations plan is only as good as your knowledge of industry trends—stay informed with our bi-weekly newsletter.