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UnitedHealthcare CEO assassinated in NYC

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Mike95060 said:
In my experience, my sons appendix removal being the data point, you get a bill from the hospital asking for whatever the insurance company decides not to cover. The hospital gives no fucks who pays them as long as they get paid. The hospital will tell you to take the disagreement up with your insurance company. They, the hospital, wants paid on their terms or you go to collections. Deal with it. And people wonder why cheap and easy healthcare gets ignored… no one can absorb a “surprise” bill they had no control over. Easier to just not get care.
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I broke my ankle on my 52nd birthday while riding out near Mammoth. Went to the hospital there, and the first thing they did was administer pain meds. After awhile they asked about insurance. I gave them my Kaiser card, as that's what we had through my husband's carpenter's union. We both had coverage through Blue Shield, also, through my job, but I hardly ever used it. Got fixed up, Kaiser paid the bill, got my receipt of payment from them, end of story. A year and a half later I get billed by the hospital in Mammoth. I ignored it, as Kaiser had already paid it, and I never heard otherwise from them. Mammoth Hospital sent no explanation or anything, just the bill for exactly what Kaiser already paid. I ignored it til I got a letter threatening collections. I guess it took Kaiser over a year to decide that since Blue Shield was the insurer through my job, I should've used them, and they decided not to pay so Mammoth refunded them. Of course, by this time I had chosen a different insurance through our mandatory yearly open enrollment, and no way was Blue Shield even entertaining the thought of coughing up some dough. I ended up footing the entire bill, even though I was doubly insured! After a very similar experience with an extremely expensive oral surgery due to a bone infection while having 2 forms of dental insurance, I dropped all coverage through my job and just went with Eric's. No problems since.
 
byke said:
Is that what claim denials essentially represent, when something goes wrong? Claims are the gap between flat rate and actual?
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Doubtful. You can be denied before a procedure. There are too many stories of "guy needs foot surgery to walk without pain, insurance covers tylenol because of XYZ, so he doesnt get the surgery" for there NOT to be some underlying truth.

Insurance and Doctors don't always agree what's best for a patient. Doctors are not correct 100% of the time and don't always do most efficient care from the start. Insurance is trying to safeguard against that. For ex, Doctors order "unnecessary" tests all the time. We might not know it was unnecessary until after the test returns no result, but Insurance is more than happy to stop many of those tests beforehand. Do you really need that chest x-ray to be more confident about pneumonia, or do we just give you antibiotics without the x-ray? What if the antibiotics don't work because you have a lung tumor instead of pneumonia?
 
Iirc, most doctors who commit fraud do so via falsely billing medicare, aka the taxpayer, for unnecessary or even un preformed procedures. I can understand why a private insurance provider would want to eliminate that but, what are the safeguards against the greed a for profit publicly traded company is supposed to covet? The result is what we have. Find every way possible to deny paying out claims. Make the process as miserable as possible for anyone trying to push back and who fucking cares if the system sucks, you have to have health insurance. It’s almost like this system is shitty or something.


Side note, all the grey hairs I work with are ELATED to be on medicare. Even though it’s imperfect too its less shitty than dealing with private insurance in their experience.
 
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Who was UnitedHealthcare CEO Brian Thompson​

From CNN's John Towfighi and David Goldman
Brian Thompson, the CEO of UnitedHealthcare, who was fatally shot in Midtown Manhattan on Wednesday in what New York police called a “brazen, targeted attack,” was a longtime leader in corporate America, a model student and star high school athlete – and he had been caught up in a high-profile insider trading lawsuit this year.
Thompson, 50, lived in Minnesota and was visiting New York for UnitedHealthcare’s annual investors conference before he was killed.
Here’s what to know:
Career: Thompson was appointed chief executive of UnitedHealthcare in 2021 and had been at the company since 2004. Prior to being named chief executive of UnitedHealthcare, Thompson worked as CEO of the company’s government programs business, which includes its Medicare and retirement businesses. UnitedHealthcare is part of UnitedHealth Group, America’s largest insurance company.
Education: Thompson graduated from the University of Iowa in 1997 with a bachelor’s degree in business administration with a major in accounting. He graduated as valedictorian, according to his LinkedIn. He was a Collegiate Scholar, Carver Scholar, State of Iowa Scholar and Faculty Scholar. Thompson graduated from South Hamilton High School in Jewell, Iowa, in 1993.
Allegations of fraud: Thompson in May was sued for alleged fraud and illegal insider trading. The Hollywood Firefighters’ Pension Fund filed a lawsuit against UnitedHealth Group, CEO Andrew Witty, Executive Chairman Stephen Hemsley and Thompson, alleging the executives schemed to inflate the company’s stock by failing to disclose a US Justice Department antitrust investigation into the company. The lawsuit claimed Thompson knew about the investigation as early as October 2023 and sold 31% of his company shares, making a $15 million profit, 11 days before the Wall Street Journal reported the probe, sending UnitedHealth’s stock sinking 5%.
CNN’s Kara Scannell contributed to this report.
 

NYPD releases images of suspect taken before fatal shooting of UnitedHealthcare CEO​

From CNN's Shimon Prokupecz, Brynn Gingras, Elizabeth Stuart, Sarah Boxer and Mark Morales
An image of the suspect released by the NYPD.

An image of the suspect released by the NYPD.
NYPD
The New York Police Department released more photos of the suspect in the shooting of UnitedHealthcare CEO Brian Thompson on Wednesday.
The images show the suspect at a nearby Starbucks on Sixth Avenue. The photos were taken around 6:17 a.m., according to a law enforcement official.
The shooting happened at around 6:44 a.m. ET, according to a timeline released earlier by the NYPD.
An image of the suspect released by the NYPD.

An image of the suspect released by the NYPD.
NYPD
 
byke said:
Is that what claim denials essentially represent, when something goes wrong? Claims are the gap between flat rate and actual?
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Nope. Claim denials are when some accountant working for an insurance company decides that he/she can increase their bonus by denying x number of claims.

Insurance companies do it all the time and Quackenbush set them up in CA (Might have changed, since, hope it did) where the max you could get is what they originally owed you....in other words, zero penalty for being assholes and trying to rip you off.
 
WoodsChick said:
I broke my ankle on my 52nd birthday while riding out near Mammoth. Went to the hospital there, and the first thing they did was administer pain meds. After awhile they asked about insurance. I gave them my Kaiser card, as that's what we had through my husband's carpenter's union. We both had coverage through Blue Shield, also, through my job, but I hardly ever used it. Got fixed up, Kaiser paid the bill, got my receipt of payment from them, end of story. A year and a half later I get billed by the hospital in Mammoth. I ignored it, as Kaiser had already paid it, and I never heard otherwise from them. Mammoth Hospital sent no explanation or anything, just the bill for exactly what Kaiser already paid. I ignored it til I got a letter threatening collections. I guess it took Kaiser over a year to decide that since Blue Shield was the insurer through my job, I should've used them, and they decided not to pay so Mammoth refunded them. Of course, by this time I had chosen a different insurance through our mandatory yearly open enrollment, and no way was Blue Shield even entertaining the thought of coughing up some dough. I ended up footing the entire bill, even though I was doubly insured! After a very similar experience with an extremely expensive oral surgery due to a bone infection while having 2 forms of dental insurance, I dropped all coverage through my job and just went with Eric's. No problems since.
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Pretty shitty. Seems like Kaiser should have billed you, not the hospital, since it was Kaiser's mistake. If I were the hospital I would have told Kaiser tough luck, you paid us a year ago and we're not giving it back. Go get it from the patient.

Also how did Kaiser find out you had another insurance plan thru your employer? And why did it take so long for them to do anything about it? Seems like a case for a good attorney, given the substantial amount of time that had passed. They shouldn't be allowed to bill you after that long. They should have warned you or refused coverage at the time of service.
 
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byke said:
AbsolutEnduser said:
so basically, if any of you care about the real news, NPR by now is reporting, that "the gun jammed at first" and then the assailant continued shooting. Soooo... ...

:wow :wtf
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byke said:
Says he cleared the jam and kept shooting. Sounds pro, or I guess they could be totally dead inside from some terrible situation.
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Might have been mentioned already but he manually cycled each round from slow mo video. My assumption is using subsonic ammo coupled with suppressor for lowest recoil and lowest noise.
 
Reli said:
Pretty shitty. Seems like Kaiser should have billed you, not the hospital, since it was Kaiser's mistake. If I were the hospital I would have told Kaiser tough luck, you paid us a year ago and we're not giving it back. Go get it from the patient.

Also how did Kaiser find out you had another insurance plan thru your employer? And why did it take so long for them to do anything about it? Seems like a case for a good attorney, given the substantial amount of time that had passed. They shouldn't be allowed to bill you after that long. They should have warned you or refused coverage at the time of service.
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Well, those are my thoughts, too. Not sure how they knew, and not sure why it was handled the way it was. I was shocked upon learning that Kaiser had demanded a refund from Mammoth. Kaiser was cagey about it but confirmed to me that they had been refunded. I actually paid Mammoth off in person while there on another riding trip, and the gal showed me the ledger with the refund to Kaiser on it.

A few months ago I got shredded pretty badly by my big orange boy cat Apollo. It happened in my own back yard. Ended up in Kaiser with nasty infections from the bites, and it took a few rounds of heavy antibiotics to clear it up. Not long afterwards I got a letter from a 3rd party hired by Kaiser trying to find out if there was anyone else who could be held liable for the damages instead of them. I told them no, of course.
 
I actually just switched to United earlier this year and over the past month they've approved every procedure I needed to diagnose my diverticulitis.
 
we’ve had united for years. no issues. only time there was any question at all was when someone else was liable for an accident i was involved in, and united was entitled to 1/3 of the settlement (they had paid all of my substantial hospital bills). i told them i would refuse to sign the settlement agreement at all unless they agreed to reduce it to 20%. i held out, and they ultimately agreed. same with my lawyer, who turned out to be a flaming asshole (caught him in a lie, and should have reported him to the bar). told him 10% or nothing. he took the offer too.
 
If one could decipher the ways of insurance, then they’d change again. Knew a Cigna claims adjuster (these folks are rarely medically trained except some who are nurses) who had an absolute $ limit per case.
Many denials are after the fact based on nebulous, undisclosed, unmet procedural criteria, usually involving documentation more than medical decision making.
Technically it is incumbent upon the insurance customer, not the hospital or provider, to know which policy is primary (usually ones own job benefit) and which policy must come second as well as the available coverage. The insurance database knows all. They even know that homeowners insurance sometimes covers injuries, dog bites or cat scratches occurring on the property and will squirm out of responsibility if possible.
 
WoodsChick said:
Well, those are my thoughts, too. Not sure how they knew, and not sure why it was handled the way it was. I was shocked upon learning that Kaiser had demanded a refund from Mammoth. Kaiser was cagey about it but confirmed to me that they had been refunded. I actually paid Mammoth off in person while there on another riding trip, and the gal showed me the ledger with the refund to Kaiser on it.

A few months ago I got shredded pretty badly by my big orange boy cat Apollo. It happened in my own back yard. Ended up in Kaiser with nasty infections from the bites, and it took a few rounds of heavy antibiotics to clear it up. Not long afterwards I got a letter from a 3rd party hired by Kaiser trying to find out if there was anyone else who could be held liable for the damages instead of them. I told them no, of course.
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I’m glad you didn’t throw your cat under the bus.
 
Eric B said:
I’m glad you didn’t throw your cat under the bus.
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😄 I totally would’ve if he’d had his own insurance policy, the little shit! We’ve spent more than $10k on medical bills for him, and he’s only 4! Broken hip at 2yo, and last month 2 nights in a hospital with a foxtail in his urethra. It’s a good thing I love him more than life itself…
 
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