I am a chiropractic provider who is in the UnitedHealthcare network. We work under their Optum subsidiary, which has bragged about how much chiropractors have saved them and their patients over the years with effective and safe chiropractic care. They have even gone so far as to waive the copayments for the first three visits in some plans to motivate patients to visit us first. While it is great to have them on the surface to show their appreciation for the great work we as chiropractors perform, there is a dark side. Abusive behavior in the past and present by UnitedHealthcare and Optum Years ago, we were in both Oxford and United, which purchased Optum as a separate division. At one time, using unrealistic statistics, they wanted all chiropractors to average 6 visits a patient, no matter what their condition, the type of practice you had, and we had to use paperwork to apply for additional visits that often were denied after a certain point. When our office could not ethically reach this level, they dismissed us from the network. We were eventually readmitted a year later because we were also in Oxford Health plans. At the same time, they were underpaying us as per their fee schedule for the manipulation performed on extremities. They did this by forcing us to use an inappropriate modifier, cutting the reimbursement in half. Years later, this was presented to the American Medical Association, which governs coding, and they were told what they were doing was inappropriate and that they now had to stop underpaying us. We were never paid for the years of underpayment for these services they certified. Their solution was to roll out a global fee program paying one fee no matter what you performed on any visit. Our office protested by leaving Oxford, as we did not want to be a dumping ground for their patients. Years later, they called me and used an ultimatum that either we take Oxford or we will be ejected from the program. Since we had several patients who were United and United Oxford, we agreed to stay in. Three years after their global fee and the elimination of precertification, they reinstated precertification, which is required for payment, even for their Medicare Advantage patients. They tied it into their tiering system, which now rates us at the top tier, almost. They are often paying us so little that it is just a waste of time and has little meaning when their plans pay so little. Since the global fee was instituted several years ago, there have been no cost-of-living increases, although we all pay more for overhead, staff, equipment, etc. Our office, like others are public servant, but is this any way to treat a profession that offers you and your patients so much? United Healthcare’s Change Healthcare disaster February 2024, many of us began to read about Change Healthcare which was a profitable subsidiary of United being hacked and they had to pay 22 Million to restore the files and months for almost half of the healthcare facilities to recover from the cash flow issues it caused. The company had a responsibility and failed miserably. We had no idea that many of our clearing houses that handle our billing were clearing through Change and we were affected too. United offered loans to doctors for cash flow but some practices failed due to their lack of protection and due diligence. Apparently, the entire thing cost us close to 900 million. There were reports of United clawing back money on these loans as doctors offices were paying them back. Our clearing house had designed a work around that improved cash flow but left us in debt as well and I had not taken a salary last August to reduce my credit line. Ironically, United has not been fined or sued for their sloppiness. More evidence that they could not care less and are all about $$$. United Healthcare’s sketchy activities under Medicare Advantage plans. Recently, they have been caught, according to the NY Times, with overcharging Medicare for their Medicare Advantage plans. We have written about these plans in the blog before, and so has the NY Times. Medicare is the gold standard for a reason. Medicare Advantage offers many roadblocks to care and has smaller networks. Many physicians no longer take patients from United Healthcare for good reason. Soon, we may join them. They want to quiet their critics for a reason; it’s money over healthcare as always. Shooting their CEO was a symbol of how frustrated patients are with private insurance. Are our legislators listening? Is it any wonder that United is trying to silence their critics. There are no shortage of these after the years of ill will and carnage left in their path. Read the latest article in the NY Times regarding United below UnitedHealth’s Campaign to Quiet Critics