Optum

[imoldernu]

Didja ever think... "Where was I when that came on the scene?"

It happened to me this morning when...up popped a blank page the said "sign in here, to read the story", with a questionnaire that asked for full name, company, title, email address and phone number.

It came up on a website that featured a news story.

Since I didn't know what Optum was, and don't like to give out my phone number I looked to Wiki for answers...

https://en.wikipedia.org/wiki/UnitedHealth_Group#The_role_of_Optum

Now I feel like the 10% that didn't get the word. On the other hand, an interesting story on how Optum came into being... lawsuits etc. On the other hand, the Optum "about us" page looks very interesting, and seems to offer a lot of information about healthcare from all standpoints... pharmacy, medical costs, success rates. It also boasts hundreds of thousands of members, with tens of thousands of healthcare providers.

Am I alone? Is this a site that you visit? What do you use it for?... Research ? Checking prices? General health questions? Other? Your thoughts?

 

[bingybear]

I had UNH at a previous employer that was the first time I had access to an HSA. OptumBank was the repository for the HSA... this would have been 2009-2010 time frame I think. So yes, I have heard of them.
Do I visit their site much now? No.. just did based on your post. Many insurance companies are working on ways to get people to live healthier lives.... it cuts their costs. I can check procedure cost estimates in my network using my present HI carrier's site. Fortunately I don't need it often.

 

[irishgal]

OptumHealth is the umbrella under which United Healths clinical programs operate. In other words, your health plan might be with United but OptumHealth is the Nurse Line, behavioral health, EAP, transplant decision support, and many more.


Sent from my iPhone using Early Retirement Forum

 

[latexman]

OptumHealth is the third party contractor for physical therapy for my company's heath coverage through Aetna. Isn't that confusing? Which is probably the reason they did it. So they can hold onto their money longer while folks figure out who to file with, what are the benefits, etc.

 

[irishgal]

OptumHealth is the third party contractor for physical therapy for my company's heath coverage through Aetna. Isn't that confusing? Which is probably the reason they did it. So they can hold onto their money longer while folks figure out who to file with, what are the benefits, etc.

So what happened is your company bought the medical plan Aetna offered, and then bought Optums PT program. Happens all the time. There a number of large national employers who do this, they may have gotten a better price by doing this, or as is customary-- one vendor offers fee based performance guarantees with their clinical programs which means if they don't perform as promised the vendor pays the employer.


Sent from my iPhone using Early Retirement Forum

 

[latexman]

So what happened is your company bought the medical plan Aetna offered, and then bought Optums PT program. Happens all the time. There a number of large national employers who do this, they may have gotten a better price by doing this, or as is customary-- one vendor offers fee based performance guarantees with their clinical programs which means if they don't perform as promised the vendor pays the employer.

Could be. This is relatively new. Aetna did the PT last year. There was no announcement by my company. There was no announcement by Aetna. The PT claimed against Aetna first, as usual. The PT was declined. They called Aetna, and only then, were they told to file with Optum. It seems communication was non-existent to the point it seemed everyone wanted to keep it a secret. And get this, Optum told me their contract says they cannot tank to me, the subscriber! That sounds like they were working for Aetna, not my company. It took over two months before the PT found out they had to submit claims to Optum. That's no way to run a business. By the time the PT filed with Optum, they were owed ~ $5000 before write-offs.

 

[irishgal]

Yep often it costs companies too much to do an employee communication. Sometimes they simply issue an addendum to their SPD which most employees will miss.
The drag about the model of using multiple vendors is it is not user friendly so the insured usually encounters a bit of frustration.




Sent from my iPhone using Early Retirement Forum

 

[latexman]

Yep, I did. I think service decreased as the debt increased!