The state’s largest health insurance company received fines totaling $457,000 from the Colorado Division of Insurance, which citied a variety of problems it found during routine market conduct examinations.
United Healthcare of Colorado received $211,000 in fines and UnitedHealthcare Insurance Co. received $246,000 in fines from the agency.
The market conduct examinations covered calendar year 2007. The companies were fined for:
Providing incomplete information in certificates of creditable coverage.
Failing to pay claims timely and accurately.
Failing to comply with the requirement for physician review.
The exam showed that people who lost health care coverage in the small group market were not offered coverage under the state-mandated basic and standard plans. The division also found several violations in policy forms by United Healthcare.
The state conducts market examinations of insurance companies to ensure that companies are in compliance with state law.
For more information about the United Healthcare violations, visit www.dora.state.co.us/insurance/mcexam/marketregchron.htm.
If you haven’t already gotten the flu vaccination, don’t plan on going to any area hospitals to get one.
A vaccination shortage for seasonal flu has caused Penrose-St. Francis Health Services to cancel the remainder of its public flu vaccination clinics. No clinics will be open the rest of the season.
Memorial Health System elected not to have any public flu vaccination clinics this year, citing a lack of available staff and resources.
To find a flu shot clinic, visit www.immunizecolorado.com/findafluclinic.asp. Some area pharmacies also are giving shots.
The Visiting Nurses Association is hosting a number of clinics — both on site and at area community centers.
Flu clinics at the VNA are only regular, seasonal flu vaccines. Call 457-4349 for updates about seasonal vaccinations and the H1N1 vaccination and for clinic hours.
Visit www.vnaa.org for more information.
In addition, Penrose also has implemented visitor restrictions at all Colorado Springs hospitals.
No one who is ill will be allowed to visit patients, nor will children younger than 12. Adult visitors will be limited to four to a room.
Visitors also might be asked to wear a mask while visiting, to visit at another time or to adhere to other precautions.
People who have weak immune systems and pregnant women are asked not to visit the hospital, unless they are sick.
The country’s health care insurers are working to save money and time by creating a single portal for paperwork.
The initiative, which will start during November, is being sponsored by America’s Health Insurance Plans and Blue Cross and Blue Shield Association.
The change could save billions of dollars in costs once it is fully implemented.
The initiative addresses the need for one-stop service in electronic transactions that doctors have advocated for, and is a requirement to achieve a significant level of savings. It will replace a cumbersome system in which office staff spend considerable time and expense accessing multiple channels to confirm billing, eligibility and referrals.
Ohio will be the first state to launch the program.
“The initiative is a reflection of our efforts to help reform America’s health care system,” said Brad Fluegel, executive vice president and chief strategy and external affairs officer for Anthem Blue Cross and Blue Shield’s parent company. “Every penny saved on forms, claims and administrative expenses is money that can be invested in innovative products and services.”
Participating health plans include Aetna, Anthem Blue Cross and Blue Shield, CIGNA, Human, Kaiser Permanente, Medical Mutual of Ohio, UnitedHealthcare and WellCare Health Plans.
Amy Gillentine covers health care for the Colorado Springs Business Journal.