NYC Health + Hospitals: UnitedHealthcare owes $11.5M in wrongful denials

New York City-based NYC Health + Hospitals claims UnitedHealthcare wrongfully denied $11.5 million in bills.

The public health system said the bills — for inpatient care provided to UnitedHealthcare enrollees— cover July 1, 2014, to Dec. 31, 2017. Now, the system seeks to recover that money through arbitration.

"For too long, NYC Health + Hospitals has been leaving money on the table and subsidizing private insurance companies by letting denials slide," said Mitchell Katz, MD, president and CEO of NYC Health + Hospitals. "Our clinicians provide high-quality care and advance our mission every day. It's our responsibility to stand up for them and challenge wrongful denials, as all health systems should."

The NYC Law Department is expected to arbitrate the dispute this summer. NYC Health + Hospitals said future arbitration against other health insurers, or similar actions, may also occur, as the system is examining current managed care contracts and denials.

UnitedHealthcare said it disagreed with the public health system's views in a statement to Becker's Hospital Review.

"We appreciate our relationship with NYC Health + Hospitals, and while we disagree with their view on these claims, arbitration will give us the opportunity to resolve outstanding disputes," according to the statement.


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