UnitedHealthCare Administrative Advocacy Committee Convenes

The AMCNO is already a participant in the UHC Physician Advisory Committee which meets on a quarterly basis to discuss issues of importance to physicians and their practice. Now the AMCNO has been invited to participate as a member of the UHC Administrative Advisory Committee. This committee is comprised of practice administrators and UHC Provider Advocates. The committee will review issues of importance to practice administrators that are currently working with the UHC provider advocates in the region. This committee will also meet on a quarterly basis. 

UHC has developed a more decentralized approach to customer service, and in order to assist with this concept they have implemented local Provider Advocates. In addition to troubleshooting problem clams, Provider Advocates are charged with providing education and training on plan processes. They are to assist physicians and their staff in understanding new plan programs, garner a better understanding of billing and claims procedures as well as to provide information on new provider service advancements that may be in development by UHC. According to UHC, Provider Advocates across the nation have reduced reworks older than 20 days to 80%; they have reduced rework turn-around time from 35 days to 8 days, and they have reduced appeals by 11% in some markets. Provider Advocates are currently working across the state of Ohio with two working in the Cleveland market. UHC is committed to improving customer service and they are tracking how successful they are at helping physicians with questions or resolving problem issues. 

The AMCNO advocates on your behalf not only with UHC but other third party payers operating in the state of Ohio. If you or your office staff has an issue involving a problem claim please contact the AMCNO offices at 216-520-1000, ext. 102. In addition, members of the AMCNO are welcome to submit issues to the AMCNO staff for discussion at the UHC advisory committees.