• AMA Reminds Physicians to File Settlement Claims against United Health Now and Offers Help through a Website
  • September 21, 2010 | Author: Jessica M. Eames
  • Law Firm: King & Spalding LLP - Atlanta Office
  • The American Medical Association (AMA) issued a press release on September 8, 2010 reminding members to file claims now against insurer United Health Group Inc. and its affiliates (United), the second largest insurer in the United States, in connection with the 2009 $350 million class action settlement concerning out-of-network reimbursements by insurers using Ingenix, Inc. (Ingenix) databases owned by United.

    The settlement resolved lawsuits initiated by the AMA, state medical societies and prosecutors in several states charging that insurers using the United-owned Ingenix database systematically underpaid physicians out-of-network claims by relying on defective methods for determining reasonable and customary fees.  Ingenix ceased operations as part of the settlement agreement.

    The deadline to file claims is October 5, 2010, but the AMA is urging physicians to file claims now.  To assist physicians, the AMA has established a comprehensive website explaining how to file claims, including: (1) a “Step-by-step guide to maximizing your recovery from the UnitedHealth Group UCR Settlement;” (2) Frequently Asked Questions; (3) the Settlement Notice and claim form; and (4) information explaining how physicians may request individual assistance from  the AMA in filling out claim forms.  Access the AMA website by clicking here.

    The settlement covers physician’s out-of-network reimbursement claims dating back to March 15, 1994.  The AMA explains that physicians seeking to file claims should first request from the United settlement claims administrator a copy of the “Defendant’s Report” that shows covered out-of-network services the physician provided to patients between January 1, 2002 and May 28, 2010.  The report, according to the AMA, can save physicians considerable time in compiling required claims information.  Obtaining a copy report, however, can take several weeks, necessitating the need for physicians to begin the process immediately.