Reuters 03/04/2010This is a recent photo. I wasn't able to find the photo from more than a dozen years ago when he was CFO at the accounting firm of Arthur Anderson LLP.
Open Letter to Mr. HemsleyMay 31, 2010
Mr. Stephen
HemsleyCEO
UnitedHealthcareDear Mr.
Hemsley;
I have a problem and now I want to make it your problem. You see, my medical claims are constantly rejected by your claims processing department. Your claims processing department agrees with me that the error is theirs when I contact them. They will reprocess the claims correctly when I call and point out their error but they only correct the old errors.
New claims are processed using the same error.
The error appears to be caused by a default assumption during the processing of claims that Medicare is the first payer. But this default is only true if the group policy is for a company with less than 20 employees.
UHC certainly must know that
DRS Technologies has more than 20 employees. In fact,
DRS has 10,500 employees in 40 plus operating locations in the United States.
How many other people’s claims are treated this way? How many others give up after being told that this policy is legal and they have no other recourse?
If this error is the default, what possible reasons are there? I can think of a few.
•
UHC’s claims-processing software has no links to your own data about the group.
• Or, though there are links to that data, a critical field for group size
isn’t linked; it was somehow overlooked or considered unimportant or…?
• Or, what I see as a problem is not a problem for
UHC because it saves
millions of dollars by not paying legitimate claims and
delaying payment of millions more?
So I
challenge you Mr.
Hemsley. Prove to me that
UnitedHealthcare has a valid reason for delaying payment of legitimate claims.
Here is a list of my legitimate claims incorrectly processed for that same error.
UHC Claim #
23
xxxxx260
23
xxxxx659
23
xxxxx007
23
xxxxx521
23
xxxxx296
23
xxxxx005
23
xxxxx036
24
xxxxx985
24
xxxxx282
24
xxxxx263
24
xxxxx098
23
xxxxx036
24
xxxxx338
24
xxxxx897
24
xxxxx897
25
xxxxx249
25
xxxxx792
25
xxxxx614
25
xxxxx166
25
xxxxx369
CC:
Mr. J.
Lippincott, Ombudsman, NJ Department of Banking and Insurance
Hon. Frank
Pallone, Jr., Congressman, US House of Representative
Sincerely,
D.A.P.