United healthcare is a situation whereby health services are combined with health insurance or it’s a combination of healthcare services and health insurance. United healthcare is one of the largest company in
United healthcare includes four divisions:
(1) United healthcare employer and individual- provides health
benefits plans and services of large national employers.
(2) United healthcare medicare and Retirement- provides health and wellness services to individuals at the age of 65 years and older.
(3) United healthcare community and state – provides services and programs that care for economically disadvantaged individual, the medically undeserved and people without the benefit of employer financed healthcare, in exchange for a monthly premium per member from the state program.
(4) United healthcare Global services – serves around 6.2 million
people with medical benefits, residing mainly in Brazil, Chile,
Columbia and Peru but also in more than 130 countries.
Health Insurance Plans
United healthcare offers commercial group insurance plans across the united states under several brand names with different offer.
(a) United healthcare select is exclusive provider (EPO) with no
coverage for out-of-network providers.
(b) United healthcare select plus is a preferred provider organization.
(c) United healthcare choice work as a WHO plan which allows for
(d) United Healthcare Navigate Charter and Compass require and primary care physician referral to see a specialist meaning that they are more restrictive managed care plans, similar to point of service plans.
United healthcare negotiate with providers in periodic contract
negotiations; contract may be stopped from time to time. High profile contract disputes can span provider network across the nation.
The provider directory should be up-to-date ever since the centers for medicare and medicaid services can fine insurers with outdated directory. As a condition of participation, united healthcare requires that providers notify them of recent changes, but also has a professional verification program that requests information from providers from time to time.
However, providers have the responsibility of having to maintain their information with different networks, so they incur cost of
A blockchain initiative began in 2018 to share information’s across directories.