Personal Finance

UPDATE: How to Fight Your Health Insurer ... and Win

Earlier this week, we told you about one of the largest health insurance schemes of all time, blown wide open thanks to one brave cancer patient who finally just said “enough.”

UnitedHealth Group, one of the nation’s largest insurers, settled with New York State over a claim by the attorney general that it underpaid patients on their out-of-network medical costs by way of owning the company that was supposed to determine those costs in an independent manner.

UnitedHealth responded in a statement:

“We respectfully disagree with the New York Attorney General’s findings that we manipulated data … [or that our ownership of Ingenix was a conflict of interest] .. We agreed to his settlement because it was an effective way to address any perceived conflict of interest.”

On Thursday, the company announced it had reached a deal to settle other similar class-action lawsuits. Going forward, UnitedHealth says it will invest in a university to be decided later as the independent voice of determined what is “reasonable and customary” for out-of-network costs.

The settlement has massive implications. If you are a customer of UnitedHealth, you could be eligible for a piece of it. But perhaps more telling is that it shows that the consumer can still effect change in corporate America.

After weeks and months of seemingly never-ending news updates of scams, scammers, thieves and con artists from Bernie Madoff to some of our largest companies, this story should be a rallying cry for all of us. We must be our own detectives and advocates, first and foremost, but the bottom line of the UnitedHealth story is that change and reform can still begin at the bottom. If it weren’t for Mary Jerome’s letter to her attorney general, hundreds of thousands of people could still be unfairly overpaying for their medical costs.

Watch the accompany video segment to see what Carmen and the Money Desk, along with a medical billing advocate, tell one viewer who was forced to get surgery at an out-of-network hospital and is now paying the price. Fortunately, she has choices.



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