Oxendine levies huge fine for delaying health insurance payments on claims

Insurance Commissioner John Oxendine levied a $750,000 fine against United Healthcare Insurance Company and its sister companies for delaying payment on thousands of health claims.

Oxendine said the firms were slow to pay about $20 million in health care claims.

The commissioner, a Republican candidate for governor, has fined several health insurance companies over the years, including United Healthcare,  for the same offense. State law  requires insurance companies to pay claims within 15 working days of receiving them, or to notify the provider or policyholder as to why a claim can’t be paid within that time.

United and its sister companies were fined $2.8 million for delaying payments on health claims in 2005. They were fined $150,00o in 2002

Insurance companies make money off the delays because they earn income from  investing premiums.

Oxendine said of United, “We’re going to keep fighting them until they get religion. We’re here to enforce the law. We will not hesitate to fine them again if they are late.”

United Healthcare responded, “United Healthcare currently processes 97 percent of its claims within 15 days in Georgia.  This settlement involves only the small percentage of claims not processed within 15 days.  Timely and accurate payment is important and United Healthcare processes 99 percent of claims for its Georgia customers within 30 days.”

55 comments Add your comment

GT Joe

November 2nd, 2009
1:07 pm

Thanks to Oxendine for helping increase our premiums… cause you know “somebody’s got to pay”

Jack

November 2nd, 2009
1:20 pm

The way Oxendine uses his office for political purposes is shameful.

Joe Biden

November 2nd, 2009
1:20 pm

If you think United’s record is bad, wait until pelosi/obamacare becomes law….
Only difference is Oxendine will not be able to “fine” us…hahaha.

dave

November 2nd, 2009
1:22 pm

C’mon insurance companies, hasn’t anyone explained that greed at the cost of someone’s health is not good? Sad, sad example of a company being forced to pay. United, you should be ashamed . . .

UGASlobberknocker

November 2nd, 2009
1:33 pm

You gotta love Oxendine..he takes no crap

Anonymous Howard

November 2nd, 2009
1:33 pm

Oxendine responded, “United Healthcare can keep their ‘facts.’ Who cares if they already settled? We’re going to keep fighting this high-profile, populist case until election day 2010 if we have to!”

HotPockets

November 2nd, 2009
1:36 pm

I don’t know about y’all but Oxendine gives me the creeps. Wavy red hair. Drives a black Crowne Victoria. Somthin’ aint right.

Not Surprised at All

November 2nd, 2009
1:38 pm

A drop in the bucket for them! For both Blue Cross Blue Shield and United Healthcare it’s financially better for them to sit on the claims, or deny for nop valid reason, then pay propmtly as they make millions in interest. Let’s see what tune they start to sing when our healthcare system goes under government control! The results are going to be scary! Governmental control means inefficiency, trillion in cost and Higher Taxes for all! Now, I understand why physicians are leaving practicing medicine, and retiring!

Hon S. Tee

November 2nd, 2009
1:39 pm

Grandstanding for the governor’s race…he has been highly ineffective and who knows how he gets re-elected.

Mark

November 2nd, 2009
1:39 pm

Oxendine is a joke. “Until they get religion”? I hope Georgians aren’t stupid enough to elect “panderer in chief” as governor.

Jamie

November 2nd, 2009
1:49 pm

And I bet he’ll be fining a lot more of them now that he’s campaigning…

BCATL

November 2nd, 2009
1:52 pm

Good to see that Oxendine has finally started to get tough with the insurance companies. Too bad it took running for governor to get his attention.

capt rick

November 2nd, 2009
1:52 pm

Big deal UHC saves millions by paying a few hundred thousand. Do you think we are morons?

TRUTH

November 2nd, 2009
1:54 pm

Whatever UHC. If this were a single payer system, you’d eliminate the middle man. Just one more question, though… Where does the fine go once its paid?

DS

November 2nd, 2009
1:56 pm

Wondering why the insurance for state of georgia employees and teachers is with this company when they are often trouble with the insurance commissioner. Personally the way they process claims (pickily relying on codes that dr.’s are clueless about) not the timeliness is my issue with them.

BCATL

November 2nd, 2009
1:59 pm

Georgia is not known as a state with tough insurance regulation. Of course, when you vote for the Elephant Party, you vote to hang your consumer rights at the door.

Arno

November 2nd, 2009
2:03 pm

United Health must not have taken the Ga. Insurance Dept. seriously to begin with if they are willing to keep violating the law.

We need tougher insurance company regulation in Ga. all the time. Not election time grandstanding.

Orangelo Moulde

November 2nd, 2009
2:03 pm

A clear example of big government intrusion into private health care issues. Real Americans don’t need “bureacraps” like Oxendine coming between us and our healthcare. UH is processing 97 percent of its claims within 15 days in Georgia. Only a liberal would punish that kind of success! I smell a RINO.

Rectal Bleeding

November 2nd, 2009
2:14 pm

Lets see how much money Oxendine will receive fromthe insurance industry for his campaign and if t changes his stance on fining these crooks.

Bill

November 2nd, 2009
2:16 pm

“They were fined $150,00 in 2002″
And just how much is $150,00?

John Nickle

November 2nd, 2009
2:16 pm

Sorry, but $750,000 isn’t to be considered a “HUGE FINE” in a case like this. 10 million would be a “HUGE FINE”.

2005 it was $2.8 million as stated. That wasn’t “huge” either in my opinion.

uberVU - social comments

November 2nd, 2009
2:37 pm

Social comments and analytics for this post…

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buzz

November 2nd, 2009
2:46 pm

It’s an election year. Time for John to get some free press.

Feed Up

November 2nd, 2009
2:58 pm

Does this explain why state employees are receiving medical bills with United Healthcare HRA. Every since Perdue got rid of Kaiser and Blue Cross Blue Shield the medical bills have been coming in. I never received any bills with Blue Cross Blue Shield. Now the premiums are going up……again………

Joe Liberty

November 2nd, 2009
3:01 pm

Bravo Commissioner Oxendine! I wrote Mr. Oxendine’s office a few years ago about United Healthcare’s delays. In my particular case I had to fight them for almost a year to stop them from wrongly charging me for portions of my bills that were their responsiblility. I was even threatened by a UHC employ to pay up (an employee that has since categorically apologized for their errors). I often wonder how people, who are much busier than I, pay their bills without question. One would think that now, with the threat of government run health care looming, insurance companies would be particularly careful and thoughtful of their customers.

Kimberly

November 2nd, 2009
3:11 pm

My healthcare provider is no longer accepting and as of 1/1/10 not seeing patients with United due to its paying history. Payments late and low.

Rob Vinson

November 2nd, 2009
3:30 pm

The “ox” getting tough on insurance companies and doing a little grand standing too and keeping his name in the paper….good for him.

lovebugs

November 2nd, 2009
3:32 pm

Uh-huh. Paying the fine is cheaper than losing out on the returns. They won’t stop until the fine is way higher than it is now. They are repeat offenders.

CherylS

November 2nd, 2009
3:41 pm

Well, finally a Republicate candidate for Governor I could vote for.

Doug`

November 2nd, 2009
3:53 pm

Why no mention that United Health Care is one of two insuance providers for State employees? We’re the ones who ultimately end up paying these fines.

Cincinnatus

November 2nd, 2009
3:57 pm

Why no mention that UHC is one of two companies that provide health insurance to state employees? We are the ones who will ultimately pay the company’s fines through still higher premiums. Thanks ever so much, Ox.

Jennifer

November 2nd, 2009
4:01 pm

BCBS has taken four months to process a dental claim I submitted. I didn’t hear anything from them and then I get paperwork telling me they have to review the claim. I call to ask if there is anything else I need to submit and they said no. I didn’t hear anything for ten business days so I called back and they told me I needed to wait an additional 10 business days because it was in another department for review yet again. I asked, again, if I needed to resubmit anything on my end and they said no. I then called back after the second 10 business days and they said that they could not read what I had submitted. I asked if they needed me to resubmit it and they said yes but this would start the review process over again. I sent in what they needed and waited, and waited, and waited. Finally, I spoke to two different managers and was told a date that the check would be sent. Was it sent? No. I called again and they said it will be sent in another 7-10 business days. All of this lasted four months with me constantly on the phone with them. It was ridiculous! To make matters worse, this was a claim that was paid monthly because it was for braces for my son. It wasn’t anything out of the ordinary and it wasn’t anything they hadn’t seen before. As a matter of fact, they require you to get a treatment plan from the orthodontist and submit that to them so they can see it. None of this should have happened and it was all over a payment of $62.00!

Mr. Thomas Anthony "The Taxman Cometh" Jones, SR, Democratic Part Incumbent

November 2nd, 2009
4:46 pm

First let me since i am a member of the Democratic party. I have never voted for Mr. John Oxendine and have voted in election since i registered to vote. I will not be voting for mr. Oxendine this year because I am a Yellow-Dog Democrat. But I do give Mr. Oxendine full credit for charging United healthcare the $750,000. While it may be an election year ploy on his part, if i was in his shoes as the Georgia Insurance and Fire Marshall I would have charged the crooks at United Healthcare twice as much. While Mr. Oxendine is a Republican, I do not giving any person his righteous due when does something right. Remembber if had a claim with the insurance companuy you would want it processed immediately by the crooks in the insurance company whether you are a Democrat, or Republican, or Libertarian. There is never ever any reason for the insurance companies to not process our claims promptly and with no delay whatsoever. The person who pays the premium is the King. The insurance companies are our servants. Good job Mr. Oxendine. You did well by the public, whether Democrat, Republican, or Libertarian. Keep punishing the insurance company crooks for us!!!

Chris Sallzmann

November 2nd, 2009
4:51 pm

Cincinnatus November 2nd, 2009 3:57 pm SAID: Why no mention that UHC is one of two companies that provide health insurance to state employees? We are the ones who will ultimately pay the company’s fines through still higher premiums. Thanks ever so much, Ox.

CHRIS SAYS: The utter selfishness of this poster is mind boggling and pretty much exemplifies everything that’s wrong with this country. UHC gets fined (and rightfully so) for something that should be a obvious and this poster is only worried about how this will effect his/her costs. No wonder this country is going to hell in a hand basket. You work for the State? Maybe the state needs to lay people like you off so you can get a reality check on how it works in the real world.

Mr. Thomas Anthony "The Taxman Cometh" Jones, SR, Democratic Part Incumbent

November 2nd, 2009
4:55 pm

As a Yellow dog Democratic Party member I have never ever voted for Mr. John Oxendine. I do not vote for any Republican politicians. But i want to say that Mr. Oxendine did right on the United Healthcare Case. If I had been Georgia Insurance Comissioner and Fire Marshall, I would have levied a twice as high fine immediately. If you let the insurance companies have their way you will get shafted. I know that this might be a ploy a Mr. Oxendine part since he is running for governor as a Republican. I expect politicians to be politician. He knows that the people detest the insurance companies and if it wasn’t for the police department many of the crooked insurance companies would have to close for safety sake. Right on Mr. Oxendine for attacking the crooked Insurance companies who steal from us the citizens of the country!!!!!

GA Girl

November 2nd, 2009
4:55 pm

For those who think Oxendine is Grandstanding for political gain, just wait until you’re in a situation where your insurance company hasn’t paid. I had to call his office years ago due an insurance adjuster for Allstate, he conviently left off some things on my vehicle claim. Had to pay out of pocket, and waited 2 months to be reimbursed by Allstate. Kept hearing “check’s in the mail, check’s in the mail”. Got tired of waiting and filed a complaint. Received a call from the Ins. Commissioner’s office telling me that they promised the check was in the mail. Was asked to let them know if I received a check in 5 days. Called back, no check. Mr. Oxendine got involved, I had my check within 2 days and the adjuster lost his GA adjusters license and his job with Allstate. Changed auto insurance companies shortly after that.

All insurance companies wait till the last minute. United Concordia is bad about it too.

Steve

November 2nd, 2009
4:57 pm

Based on my experience with UHC, it is not a well managed companty. The government is worse.

Tucker

November 2nd, 2009
4:57 pm

BCBS Ga gets a free ride since Oxendine sleeps with one of their Executives.

This is nothing but election year political grandstanding! Step up other Republicans. This guy is a joke!

ATL Guy

November 2nd, 2009
5:03 pm

Why do Republicans like to talk like “We the People”, “Our Founding Fathers”, etc? Do they think it makes them sound patriotic? The Republican Party today is the most unpatriotic body in politics today. They are Talibanic in their approach to governing. Either you’re with them 10000% or you’re an enemy to be tarred and feathered. They’re eating their young by running moderate Republicans out of their midst in the search for ideological purity.

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dunce

November 2nd, 2009
5:32 pm

Here’s how it went down: OX: “Uh, Jim, we’re gonna have to fine you so I can make political hay and get my ass elected. You see, the people of Georgia are in a foul mood about the healthcare system and you guys not paying like you should and I need to get on the right side of the track with this. How ’bout 750K?”
UHC: “Okay, but that counts as our contribution to your campaign! And we need to hang on to a bunch of money after this blows over, deal?
OXENDINE: Deal.

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citizen

November 3rd, 2009
8:48 am

UHC sees these fines simply as a business expense. The interest they earn on the money from our premiums makes these delayed payments very profitable for them. They are too rich and powerful to let state governments or their clients bother them. Making money is their only business and they are good at it.

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Lucas

November 3rd, 2009
10:35 am

They get fined every year. If he was doing his job, they wouldn’t pay late.

Base

November 3rd, 2009
4:51 pm

All insurance companies are crooks,that is how they make there money.The question is why Sonny let United Healthcare be a provider for state workers if they have such a bad history.Sounds like Sonny needs the IG to look at Dept of community health.

Anonymous Jeffy

November 4th, 2009
9:03 am

Hmmm. Does it take a political election for this guy to wake up and put pressure on the companies he is supposed to regulate?

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catlady

November 7th, 2009
8:24 am

My claims have been slowplayed several times, with requests for information that was there on the form all along. In addition, “State Merit” tried to pass off the birth of my son on my car insurance (no part of his birth or conception had anything to do with a car), wanted to know if brain surgery had taken place in the hospital or dr’s office(they had already paid the hospital part of the bill), and did not question the charge for a stomach drain when his finger got 6 stitches!

My theory: most of it is greed, but some is simple incompetence!

dmac

November 8th, 2009
7:36 am

“State law requires insurance companies to pay claims within 15 working days of receiving them, or to notify the provider or policyholder as to why a claim can’t be paid within that time.”- This is the problem. Insurance companies use every excuse in the book to delay payment. They send you notification within the 15 day limit that they need more information in order to process your claim. Sometimes they just deny the claim and then only after you’ve made dozens of phone calls do they eventually make partial payment.

WE NEED HEALTH CARE REFORM!

catlady

November 8th, 2009
6:33 pm

Can anyone recommend a good insurance policy/company for a newly married couple, aged 24 and 39, with no serious physical illness history? What they are looking at is INSANE, with 7000 deductibles, 1000 perscription deductible in addition, etc. They do not plan to have a family. Female has had mental health counseling/meds for several years. Anyone make a recommendation?

insider

November 9th, 2009
7:59 am

Just an fyi Oxendine’s wife works for Blue Cross Blue Shield of GA, she obviously has a different last name, but she still works there.

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