UnitedHealth plagued by complaints since assuming Tricare contract

UnitedHealth is facing scores of complaints, including long backlogs for members to reach customer service and delays in providers obtaining referrals, since taking over a huge $20 billion contract to provide coverage to the western region of Tricare. The nation’s largest insurer claims the delays are caused by requests for referrals and authorizations that “far exceeded the norms” since UnitedHealth assumed the contract from TriWest on April 1. Since UnitedHealth’s contract includes “provisions for the recovery of costs due to poor performance,” Tricare might require the insurer to reimburse it for costs associated with these problems. Tricare members and doctors have begun contacting lawmakers, who in turn have written to UnitedHealth execs for a solution. Rep. Walz (D-Minn.) sent a letter to UnitedHealth CEO Stephen Hemsley, requesting he explain the challenges the company has faced since taking over the Tricare contract. UnitedHealth says it “understands the issues we need to improve on, and we are taking aggressive action,” including deploying more employees to process the requests. It hopes resolve all the issues in about a month.