Corporate Compliance

Medical group sues health plan over payments

Compliance Monitor, June 6, 2007

Two state agencies have started investigations of UnitedHealth Group Inc. over alleged misconduct including late and inaccurate payments and making it more difficult for patients to get access to medical services.

At the same time, a local medical group has sued the company over similar allegations. The lawsuit filed May 15 by Radiological Associates of Sacramento Medical Group Inc. alleges a UnitedHealth subsidiary is not paying what it is supposed to under a four-year-old contract.

The lawsuit appears to be the first since the merger over widespread complaints about administrative hassles, inaccurate payments and chronic delays in claims processing. The problems allegedly have held up payments to doctors' offices and affected patient access to services.

Both the California Department of Insurance and Department of Managed Health Care are investigating the complaints.

Source: Sacramento Business Journal

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