According to the New York Times, the Big Data firm MultiPlan and insurance companies may be conspiring to cut payments to doctors, leaving you holding the bag for any overages.
If you’ve had to pay out-of-pocket for out-of-network healthcare that your insurance company refused to cover, you may be a victim of this "Unconscionable Practice[]". We can help.
Contact us now for a free, no-obligation consultation.
How it works: Major insurers contract MultiPlan to advise them on how much they should reimburse doctors for a out-of-network medical care. MultiPlan uses prorprietray algorithms to recommend how much to pay for this care. Allegedly, MultiPlan has helped these major insurers conspire to cut payments to providers to well below the charged amount. This can leave unpaid balances, which the patient (you), then become responsible for.
In a recent letter to regulators Senator Amy Klobuchar stated:
"Algorithms should be used to make decisions more accurate, appropriate, and efficient, not to allow competitors to collude to make healthcare more costly for patients." - Senator Amy Klobuchar
The American Hospital Association has also urged the Labor Department to Investigate MultiPlan’s “Unconscionable Practices” – which end up costing patients and employers for necessary care.
Major insurers like UnitedHealthcare, Cigna, Aetna, Kaiser Permanente and Humana, among others all have used MultiPlan to reduce the amount they pay for care while increasing the amount that you have to pay!
The less MultiPlan recommends the insurer to pay of a provider’s bill, the larger the fee that MultiPlan collects. This system of perverse incentives enriches the insurance companies and MultiPlan, and shifts the responsibility for the unpaid balance on the treatment to the consumer.
Patients hit with these bills sometimes skip care, stop long-term treatment, or face serious financial difficulty.
If you are concerned that you have been charged excessively for out-of-network care as a result of your health plan, we want to hear from you.
Call (800) 776-6044, email [email protected], or complete the form on this page for a free consultation.
More on this issue in the news
- New York Times: Health Insurers' Lucrative, Little Known Alliance: 5 Takeaways
- AHA.org: Following NYT investigation, AHA urges DOL to investigate actions of MultiPlan and commercial insurers
- MedCity News:AHA Urges Labor Department to Investigate MultiPlan’s ‘Unconscionable Practices’
- New York Times: Collusion in Health Care Pricing? Regulators Are Asked to Investigate
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