Health Insurance Customers Who Appeal Their Claims Often Win
The Wall Street Journal reports that of the 850 million claims denied annually, less than 1% are appealed. Of that 1%, nearly three-quarters of appeals are approved. Also in the news: Washington Hospital workers avoid a strike; Walgreens explores its options for its health care clinic; and more.
The Wall Street Journal:
Health Insurers Deny 850 Million Claims A Year. The Few Who Appeal Often Win.
After three years of doctors’ visits and $40,000 in medical bills didn’t cure their daughter’s rare condition, April and Justin Beck found a specialist three states away who offered a promising treatment. They set out before dawn last spring for the nine-hour drive to Arkansas Children’s Hospital in Little Rock, where Dr. Aravindhan Veerapandiyan explained how infusions of antibodies could help Emily, now 9 years old, and her misfiring immune system. (Wernau, 2/12)
The Wall Street Journal:
Five Steps To Take If Your Health-Insurance Claim Is Denied
Few people realize how worthwhile appealing a denied health-insurance claim can be. Insurers in the U.S. process more than five billion payment claims annually, federal figures show. About 850 million are denied, according to health-policy nonprofit KFF. Among the fewer than 1% of people who appeal, up to three-quarters are successful. Here are five things you can do to appeal a denied health-insurance claim. (Wernau and Mathews, 2/12)
More health industry updates —
CBS News:
SEIU Healthcare Workers At UPMC Washington Hospital Reach Contract
Union workers at Washington Hospital have reached a contract, avoiding a strike. The union says the contract includes average raises of 12% over three years. UPMC Washington confirmed the three-year collective bargaining agreement with SEIU Healthcare has been ratified. (Behanna, 2/12)
Bloomberg:
Walgreens’ VillageMD Taps Advisers As Backer Pursues Exit Plan
VillageMD, the health care clinic chain backed by Walgreens Boots Alliance Inc., is working with Evercore Inc. for assistance as explores options that include a sale or restructuring of its operations, according to people with knowledge of the matter. The health care provider is also working with Alvarez & Marsal Inc. for operational help, said the people, who asked not to be identified discussing a private matter. (Basu, 2/12)
Modern Healthcare:
Tenet's Ambulatory Investments Pay Off, CEO Saum Sutaria Says
Tenet Healthcare's portfolio transformation toward ambulatory care is paying off. For-profit Tenet added nearly 70 new and acquired ambulatory surgery centers last year through its United Surgical Partners International business, CEO Dr. Saum Sutaria said on a Wednesday earnings call with investors. The health system plans to invest another $250 million this year into ambulatory care, including plans to add 10 to 12 de novo ASCs, he said. (Hudson, 2/12)
Modern Healthcare:
Fairview Will Not Merge With Essentia, University Of Minnesota
Fairview Health Services is not looking for a merger partner right now. Minneapolis-based Fairview said Wednesday it does not support merging with Duluth, Minnesota-based Essentia Health as part of a larger plan with the University of Minnesota to form a nonprofit entity that would boost financial support for the school. (Hudson, 2/12)
Modern Healthcare:
Private Equity Investors Worry As States Debate Oversight Bills
States' fight to clamp down on private equity deals in healthcare isn't over, despite recent setbacks. Proposed legislation in states including California, Connecticut and Minnesota fell flat last year, raising questions about future oversight efforts affecting private equity transactions. However, the new year brought renewed support for state legislation ranging from stricter reporting requirements to stipulations on certain operational models. (Hudson, 2/12)
