Emily Benson can see UnitedHealth Group's headquarters from her office in Edina, but that proximity made it difficult for her clinic to get emergency funding from the company.
Benson's mental health clinic is filing the bill through a subsidiary of UnitedHealth Group, which shut down its systems more than three weeks ago due to a cyberattack.
So Benson and eight other therapists at Beginnings & Beyond Counseling are essentially without income, relying on a $40,000 loan they took out from UnitedHealth earlier this month.
The company's first free assistance program after the hack offered only $1,100 a week, a fraction of the clinic's total insurance claims, so she relied on this funding, which included a $780 fee. Ta.
Benson emphasized that she values the relationship between UnitedHealth and its beneficiaries, saying, “They give us money, but it's so little that it's not helpful.” It's the amount,” he said. “I want to be honest about how hard we are struggling.”
Beginnings & Beyond is one of three Minnesota health care providers that told the Star Tribune this week that they are working to fully close the funding gap hitting thousands of hospitals and clinics across the country. said he was unable to take advantage of UnitedHealth's financial assistance program.
The cyberattack targeted UnitedHealth, which operates a widely used clearinghouse for electronic claims data that processes 15 billion medical transactions annually and touches one in three patient records in the United States. It targeted its subsidiary, Change Healthcare. UnitedHealth Group is cooperating with the federal government's investigation into the cyberattack while rushing to restore Change Healthcare System, which was shut down to contain the threat.
By the end of the week, there were signs of improvement for health care providers seeking financial support. After the Star Tribune contacted Minnetonka-based UnitedHealth about all three situations.
UnitedHealth's Temporary Assistance Program began March 1 for two small, independent clinics in the Twin Cities, with need assessed based on a far-from-complete review of past claims. As a result, the clinic considered the amount offered to be insignificant. This discrepancy has been reported in recent weeks by other health care providers in Minnesota and across the country.
After hearing stories like this, “We didn't even bother applying,” said Gretchen Moen, clinical director at Dakota Child and Family Clinic in Burnsville.
Late last week, UnitedHealth launched a new “last resort” funding program aimed at providing additional support, especially to smaller community health care providers.
“We are currently working with thousands of health care providers, from large regional health systems to small independent practices in rural areas, to assist with their cash flow challenges,” UnitedHealth said in a statement to the Star Tribune on Friday. We are working with the organization.”
Robbinsdale-based North Memorial Health is stuck with hundreds of millions of dollars in claims and negotiations over funding continue.
The health system said in a statement Tuesday that “the amount offered…was insufficient to resume normal cash flow operations.”
North Memorial added Thursday that “talks are fluid. We expect a short-term and temporary resolution within the next few days.”
Frustration expressed publicly by some small practices and privately by some large health systems led to swift launch of support programs for some seriously affected providers. This reflects United Health's challenges. This includes groups that have used Change Healthcare's claims processing clearinghouse exclusively.
UnitedHealth on March 7 announced a last-resort funding program to provide assistance on a case-by-case basis to medical groups with no other options after the American Hospital Association criticized the company's early assistance program as insufficient. Announcing improvements to the program.
“We are determined to remedy the situation as quickly as possible,” UnitedHealth Group CEO Andrew Whitty said in a statement.
Amy Tannahill, a nurse practitioner at Roseville's Rosenberg Center, said UnitedHealth's first program provided her practice with loans of just $90 a week. She called the amount “ridiculous” because it's less than the cost of one standard visit.
In lieu of UnitedHealth's offer, Tannahill and her fellow clinic owners are considering everything from tapping into their personal savings to finding a lender that would offer more help. Temporarily closing is an option, but Tannahill said the clinic feels an obligation to continue caring for patients.
The Rosenberg Center serves children with developmental and behavioral needs.
“I would like to see [United] Please take this issue seriously and prepay your payment immediately [for] Providers and support staff who should be paid for their work,” Tannahill said in an email Tuesday. [United] Last year it had a profit of $22 billion. ”
On Thursday, the Rosenberg Center received a call from UnitedHealth offering further assistance.
“I informed the representative that I was billed approximately $170,000 and requested that amount,” clinic manager Mary Thyssen Thompson wrote in an email Friday. “He said he would receive the information and confirm within five days if it was approved.”
She added: “We would be completely shocked if they paid that amount.”
Benson said at Beginnings and Beyond Counseling that she was contacted Thursday by a UnitedHealth representative about a $40,000 interest-free loan. She said she had already borrowed that amount from the existing UnitedHealth loan program just before the new last resort program started.
“I asked him to waive that right. [$780] I am being charged a fee in lieu of his offer. He said the request needed to be escalated,” Benson said in an email.
Benson's first loan would be limited. Benson said a representative from another company on Thursday encouraged her to apply for assistance through the Last Resort Program, but she “ran into trouble” when she tried to do so, which she received Friday morning. He provided the Star Tribune with a screenshot of the message.
“Page kept denying my requests,” she said. “I tried it three times.”
Some health care providers are less tolerant of the problem, having already invested so much energy in recent weeks trying to use the claim submission “workarounds” that UnitedHealth has been touting.
Benson's clinic income went from about $70,000 a month to “almost nothing.” This is because her medical records system relies solely on her healthcare clearinghouse for bill submissions. UnitedHealth Group is encouraging practices like hers to use alternative systems, but Benson says that's not viable.
She had to download information for each patient visit and submit the data through a combination of electronic and manual steps, depending on the health insurance company. When Ms. Benson tried this, she found that the process of filing just her one claim took about 6 to 7 minutes.
“I'm a single mother of eight practitioners. I can't do that,” she said. “I don't have an office staff because I'm too small.”
An even bigger problem is that once the Change Healthcare system is back up and running, claims filed through the workaround could trigger her medical records and send the patient a double bill for the costs she incurs. That's what she said. Benson hasn't filed any claims so far and says she plans to wait until the system starts up again, even though patients may receive multiple out-of-pocket bills at once. she states.
“We had to send a letter to everyone we serve, about 250 customers, saying, “This is what's happening now. Be prepared to get a big bill because we’re not going to do that.’ We can stagger payments,” she said.
At North Memorial, Change's closure effectively halted all claims submissions and many electronic payments to the health system, said Nate Dell, vice president of revenue cycle management.
Some funding has arrived based on applications submitted before the Feb. 20 attack, but this revenue is “precipitously declining,” Dell said.
“We have hundreds of millions of dollars in unbilled receivables,” he said in an interview last week.
Because insurance companies negotiate deep discounts from your health plan's rates, these bills list amounts that are significantly larger than what you end up paying.
At North Memorial, patient care generates approximately $18 million per week. Financial reserves exceeded $300 million at the end of last year, according to a Star Tribune review of financial statements.
Still, Dell said the system failure caused “extreme disruption” to the health system, which employs about 5,000 people across two hospitals, more than a dozen clinics and a large emergency service.
“This is a once-in-a-century storm that no one planned for, and you can't insure yourself,” he said.
