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NYCHH Seeks $11.5M from UnitedHealthcare for Denied Claims

NYC Health + Hospitals is pursuing arbitration with UnitedHealthcare in order to recover $11.5 million in denied claims.

NYCHH seeks $11.5 from UnitedHealthcare

Source: Thinkstock

By Thomas Beaton

- A New-York based health system has initiated arbitration with UnitedHealthcare in order to collect $11.5 million in denied reimbursement from claims.

NYC Health + Hospitals, a public healthcare network that serves New York City’s five boroughs, launched an arbitration campaign to collect reimbursement from several commercial payers, starting with UnitedHealthcare. NYC Health + Hospitals will collaborate with the New York City Law Department to arbitrate the dispute.

“Our pursuit of arbitration is just one component of our new approach to working with our managed care partners,” said Matthew Siegler, Senior Vice President for managed care and patient growth at NYC Health + Hospitals.

 “We expect to have very productive relationships with health plans as we work together to improve access and patient experience across our system. Negotiating fair rates and terms with private insurance companies and collecting accurate payment for services rendered are critical elements of those relationships.”

Mitchell Katz, MD, President and CEO of NYC Health + Hospitals argued that commercial payers such as UnitedHealthcare have been able to deny claims to manage spending without any real challenge from provider organizations to appeal denials.

“For too long, NYC Health + Hospitals has been leaving money on the table and subsidizing private insurance companies by letting denials slide,” said Katz. “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.”

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