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UnitedHealthcare reconsiders pandemic underpayments

UnitedHealthcare is reprocessing claims related to COVID-19 vaccines, per an October 21 article in Modern Healthcare. What’s that saying about measuring twice and cutting once?

When it comes to underpaying for COVID-19 care, you almost can’t blame UnitedHealthcare for trying. Well, actually, we can.

After providers, largely pediatricians, complained that United was paying them substantially below market rate to administer COVID-19 vaccines, UnitedHealthcare has now committed to reprocessing commercial claims. Now, this isn’t just the simple task of reprocessing a few missed claims. This affected “millions” of providers, according to Modern Healthcare, so it’s no small feat.

While there isn’t a legal requirement for health plans to pay a federal rate, the company stood out as the only insurer that hadn’t agreed to a reimbursement rate of at least $40. According to the article, reports also indicate United pays less for COVID-19 tests.

Per the article, the Senate Aging Committee is requiring the organization to provide answers about how many providers have been affected, and how much the organization will owe: “For every 1 million claims UnitedHealthcare reprocesses, the company will owe providers $15 million,” the article reports. (WHOA.)

Can’t say we’re surprised that this policy resulted in egg on UnitedHealthcare’s face. But as we’ve said before, why does the company constantly have to be cajoled into doing the right thing?

Now, let’s talk about the huge administrative undertaking of reprocessing these claims. Not only is all that time wasted, but there are also administrative dollars involved. These are enormous efforts – all for claims that wouldn’t have to be processed if United would’ve forked up the initial $40 at the get-go. United, you’re wasting precious time. And dollars.

Policies like underpaying for COVID-19 vaccines benefit absolutely no one – except United. And as the largest health insurance company in the country by every metric, one could argue that UnitedHealthcare bears responsibility for the health of more patients than any other single entity.  Shouldn’t that entail some due diligence, and in a global pandemic, no less?

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