Capatt schiesst Malans ins Halbfinale

I work United Healthcare denials edaeyvry. We are considered a blind or uncontrolled provider. These providers are the Radiologist; Anesthesiologist; Pathologist; Lab, and Emergency Room Physician. The term United Healthcare uses, internally, is RAPLE providers. As a non-par Radiologist, of course, depending on the patient's benefit plan claims are suppose to be paid at the in-network benefit level, Being a non-contracted provider, when the patient presents to a par-facility (hospital), the claim is supposed to be processed and/or considered at the billed amount, not their usual & customary or their reasonable & customary amount. United Healthcare uses the term eligible expense . What most providers and patient's do not know is that they are suppose to consider all charges at the billed amount. These RAPLE providers actually get a better return if you are not a contracted provider. What the insurance companies (including United Healthcare) fail to inform their providers and members is that when a patient presents to a participating hospital (facility) United Healthcare is suppose to enhance and process at the in network benefit level even though we are non-par. Recently, as part of their strong-arm tactics to force physicians to participate they have decided not to honor our assignment of benefits for small group employers only . That means, if we file a claim on the patient's behalf who has a private policy or a small group policy, United Healthcare will pay the patient directly for our services. BCBS used to do this to us when were were non-par. We just had too many BCBS patients, therefore their strong-arming tactic worked, and we joined them. Even as a par-provider with BCBS, they still process our claims incorrectly. They are forever paying the facility (hospital) claims, however denying our claims. They actually try to get away with paying for 1/2 of the claim (we bill for the PC =professional component and the hospital (facility) bills for the TC -technical component.) They try to get away with it. **The important thing to remember is that you have to keep on top of your denials. You much work them. I call United Healthcare, CIGNA Healthcare, and AETNA, pretty much on a daily basis, getting them to reconsider and reprocess our claims to be enhanced in network and considered at our billed amount and not their allowed or eligible amount. It takes a while, several appeals, however, most of the time, they actually end up paying. I am a physican and patient advocate. We are a small group however I have recovered over $500,000 in the past 4 years. They may not see like much, but that is $500,000 less that the patient had to pay us because insurance companies like United Healthcare continue to get away with what they do. If these insurance companies were investigated, it would probably pay the entire 1.3trillion dollar deficit that the new President Elect is going to inherit. I wish he would contact me to work in the White House, I definitly could get some serious financial recovery for the entire United States of America. **If there is anyone that needs my help and expertise with getting claims paid and that goes for physicians/providers or patients, please feel free to email me. I guarantee you I can help and may also be able to recover some of your money.