Monday, May 31, 2010

Dan Trim Made Me Do It

Dan has a Mothing Blog (Check it out).
Though moths have always facinated me I don't usually take many photos of them. But it just so happenes that today I spotted an interesting one that I had never seen before. So I'll post it here along with another interesting one that I shot a few years ago.

Beautiful Wood Nymph - Eudryas grata. It's a small (2.2 cm) moth in a huge and diverse Family, Noctuidae also called Owlet Moths.

The second moth, and Eight-spotted Forester, Alypia octomaculata, is also in the Family Noctuidae. Alas, its photo has gone missing this evening. I also had a photo of the larva which is memorable because it causes a painful reaction if you touch one of its many spines.
Until I locate it, there are several good photos on Flickr. This Eight-spotted Forester is by Ms. Gould.
The Forester's larva here is by Roy Niswanger.

Is this How Hemsley at UnitedHealthcare Manages Costs?

Reuters 03/04/2010

This 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. Hemsley

May 31, 2010

Mr. Stephen Hemsley
CEO UnitedHealthcare

Dear 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 #

Mr. J. Lippincott, Ombudsman, NJ Department of Banking and Insurance
Hon. Frank Pallone, Jr., Congressman, US House of Representative