Provider spills the beans
Former Falcon Physical Therapy owner, Lorne MacDonald has seen the changes with UnitedHealthcare insurance since it took over coverage for thousands last April. It's a story I've seen evolve since the takeover. There was a huge meeting in May between healthcare providers and Congressman Doug Lamborn. The problem then was slow payments to health providers and even slower referrals.
MacDonald says that problem for the health community has changed, "With UnitedHealthcare now, if the authorization goes through and that's a big if, we get paid within seven to ten days. It used to take 30 days or longer." He said patients are still getting short-changed. He told me his concern for at least one patient he knows, "She has thyroid cancer. Now it's spread and it's been a nightmare to get authorizations for radiation and chemo. Every time she turned around, they would deny, deny, deny it. Doctors finally could do surgery on her and discovered that the cancer had spread."
MacDonald believes that something has to change in favor of a UnitedHealthcare patient. His advice to those waiting for authorizations and getting mired in paperwork pain is, "All I can do is tell people to keep slugging away. They're going to give in."
I've been trading emails with UnitedHealthcare to get their take on streamlining the process for patients to get help for them faster.
I also contacted Congressman Doug Lamborn's office to get his feeling on the situation. Here is what he said in an email:
“I have been engaged with UnitedHealthcare since the beginning of the contract to address all problems and challenges that directly impact our TRICARE beneficiaries and providers. My staff has had much success in resolving problems as a result. I appreciate the support of UnitedHealth CEO Steven Hemsley in resolving issues in a timely manner. I would encourage any provider or beneficiary to contact my office if you are in need of assistance.”
The Congressman's contact information is on KRDO.com. Just go back to our big stories section and click on our hot button story.
You can also email email@example.com. He is with Congressman Lamborn's office and will help you directly if you are having UnitedHealthcare problems.
Copyright 2014 KRDO. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.