HealthCare Partners joins BC Select HMO network

HealthCare Partners joins
Blue Cross Select HMO network
Effective January 1, 2008, HealthCare Partners officially joined the Blue Cross Select HMO provider network alongside its other prestigious partners.
Giving members access to an extensive network of excellent, contracted providers and quality, cost effective coverage is always a top priority within the Select HMO network, and the inclusion of HealthCare Partners helps attain this goal. A multi-specialty medical group dedicated to the well-being of members and their communities, HealthCare Partners has more than 40 convenient medical offices, including five urgent care centers and hundreds of affiliated medical offices located throughout the Greater Los Angeles and Orange County area. By giving members access to more than 800 Primary Care Physicians, the addition of this medical group will help retain existing business while also attracting new members.
HealthCare Partners has long been a participating medical group with Blue Cross. This change expands our relationship and makes this marquee group available to our Select HMO members. HealthCare Partners is currently available on ProviderFinder.

PacifiCare accused of widespread violations.

PacifiCare accused of widespread violations
It could face $1.3 billion in penalties for allegedly mishandling claims.
The Associated Press

SAN FRANCISCO – Health insurer PacifiCare could face as much as $1.3 billion in penalties for allegedly handling claims unfairly following its takeover two years ago by UnitedHealth Group Inc., state officials said today.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
California regulators investigated and uncovered at least 130,000 alleged violations of state laws and regulations regarding payments for medical care, California Insurance Commissioner Steve Poizner announced in a statement.
A maximum penalty of $10,000 applies to each violation, which include wrongful denials of covered claims, incorrect payments, lost documents and delays in handling claims.
"After years of broken promises to California regulators, it became crystal clear that PacifiCare simply could not or would not fix the meltdown in its claims-paying process," Poizner said.
Minneapolis-based UnitedHealth purchased Cypress-based PacifiCare for $9.2 billion in January 2006. More than 3 million Californians were added to UnitedHealth in the deal. The company now has about 27 million enrollees nationwide.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
UnitedHealth officials said problems occurred when the company tried to make too many changes too quickly.
"The pace of the transition may have resulted in some physicians and other care providers experiencing inconsistent service in the past," spokesman Tyler Mason said.
PacifiCare had already disclosed many of the issues raised by regulators prior to the investigation and was taking "aggressive steps" to make improvements, Mason said.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
PacifiCare was also fined $3.5 million by California's Department of Managed Health Care over the alleged violations.
Department of Insurance investigators reviewed PacifiCare claims processed between July 2005 and May 2007 following complaints from patients and doctors, Poizner said.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
The maximum fine will apply only if authorities prove all the violations and show they were committed as part of a deliberate scheme.
UnitedHealth's regional chief executive David Hansen said the "vast majority" of the violations were administrative errors that did not harm PacifiCare members. More than 80,000 of the violations, he said, stemmed from not sending health care providers letters acknowledging that claims were received, even though most of those claims were paid on time, he said.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care

Blue Cross of CA to become Anthem Blue Cross

Blue Cross of California to become Anthem Blue Cross

Starting April 1, 2008, Blue Cross of California will begin to do business as Anthem Blue Cross, taking on a trusted brand name that symbolizes quality for millions of consumers across the country.

This means Blue Cross of California products and services will be offered under the Anthem Blue Cross brand. Blue Cross of California’s affiliate, BC Life & Health Insurance Company, will also adopt the Anthem brand and change its name to Anthem Blue Cross Life and Health Insurance Company.

The brand change to Anthem will apply to our complete product portfolio, including medical, dental, vision, life, employee assistance programs and behavioral health services.

The Anthem brand, used by 11 other health plans across the country, is well recognized and known for quality, affordable health care coverage. With a strong reputation in the market as a trusted choice for consumers, the Anthem brand name embodies the same consistency, strength, security and stability as the Blue Cross of California name.

Stay tuned for more information as it becomes available.

Julia