The Department of Insurance found United Healthcare violated state insurance laws by limiting coverage to 26 visits per year. In other cases, the department says the company failed to evaluate the medical necessity of treatment before denying claims.
"When Missourians entrust their health coverage to an insurance company, they expect and deserve to be treated fairly and legally. We have taken this action to make sure that happens," said John M. Huff, Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP). "We believe the review of these 50,000 files may determine money is due to other providers and possibly consumers."
For any chiropractic claims it finds were improperly denied, United Healthcare must reimburse the physicians for those claims, plus interest. In some cases, consumers may have paid the bills, rather than the chiropractors. Those consumers should contact United Healthcare at 800-873-4575. Patients or chiropractors with questions about the settlement can the Department of Insurance Consumer Hotline at 1-800-726-7390 or visit insurance.mo.gov.