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Statewide UHC/OPTUM Survey
Statewide UHC/OPTUM Survey
We are addressing an issue brought to our attention by a large group of medical practices. The issue involves claims filed on behalf of United Healthcare (UHC) patients.
We have been advised that often, once the claims are filed, the medical practice receives a request for additional medical information, either from UHC or its utilization review entity, Optum.
Subsequently, the practice calls to request the status of the claim based on the additional information submitted. Regrettably, the practice is often advised that the records were not received. Based on further discussion during the call, the practice is told the records were sent to an incorrect address.
MSSNY has been interacting with UHC on behalf of our members in reference to this problem since June 2019.
Due to the length of this ongoing burden, MSSNY is now seeking assistance from the NYS Department of Financial Services (DFS). Therefore, we are asking you for further information to address this matter. DFS is regulatory authority over NYS regulated health plans/insurers.