NYC Health + Hospitals is pursuing arbitration to recover $11.5 million in what it calls wrongfully denied bills submitted to United Healthcare.
"For too long, NYC Health + Hospitals has been leaving money on the table and subsidizing private insurance companies by letting denials slide," said Mitchell Katz, MD, president and CEO of NYC Health + Hospitals. "Our clinicians provide high-quality care and advance our mission every day. It's our responsibility to stand up for them and challenge wrongful denials, as all health systems should."
The bills reflect care provided to United Healthcare beneficiaries in the inpatient settings of NYC Health + Hospitals between July 1, 2014 and Dec. 31, 2017, the health system said.
The NYC Law Department, which represents the City and its affiliated agencies in legal matters, will be responsible for arbitrating the dispute, which is expected to take place in Manhattan later this summer.
NYC Health + Hospitals, which has a managed care contract with UnitedHeathcare, said it is reviewing all of its current managed care contracts and denials as it modernizes financial operations.
The system also said it may pursue arbitration against other health insurers or take similar actions to appropriately collect revenue it is due.
"Negotiating fair rates and terms with private insurance companies and collecting accurate payment for services rendered are critical elements of those relationships," said Matthew Siegler, senior vice president for managed care and patient growth at NYC Health + Hospitals.
"For too long, NYC Health + Hospitals has been leaving money on the table and subsidizing private insurance companies by letting denials slide," said Mitchell Katz, MD, president and CEO of NYC Health + Hospitals. "Our clinicians provide high-quality care and advance our mission every day. It's our responsibility to stand up for them and challenge wrongful denials, as all health systems should."
UnitedHealthcare responded by statement.
"We appreciate our relationship with NYC Health + Hospitals and while we disagree with their view on these claims, arbitration will give us the opportunity to resolve outstanding disputes," said spokesman Daryl Richard, vice president of Corporate Communications.
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com