North Carolina fines UnitedHealthcare $3.4M for claims handling practices – BenefitsPro

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The insurance giant complied by denied violating statutes, rules, or regulations.

MINNETONKA, MN/USA – MAY 29, 2016: UnitedHealthcare corporate headquarters exterior and sign. UnitedHealth Group Inc. is an American diversified managed health care company. Credit: wolterke/Adobe Stock;

In the wake of a four-year investigation of claims handling practices involving balance billing, North Carolina has fined UnitedHealthcare $3.4 million. In addition to paying the fine, the insurance company agreed to provide the state’s Department of Insurance with a corrective action plan to address violations uncovered during the investigation, as well as submit to future compliance examinations.
According to the North Carolina Department of Insurance, the investigation targeted UnitedHealthcare’s handling of member grievances and claims processes involving non-contracted or out-of-network providers and facilities for anesthesia services and emergency room services to see if the company was following its procedures to protect members from balance billing and complying with North Carolina law.
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