Too Big to Fail: Perception of Payer Infallibility

Are commercial payers too big to fail? Do they operate with the sense of infallibility? Case in point: UnitedHealthcare Group, which according to its earnings report, posted $4.1 billion in profits in the fourth quarter of 2021. Is the playing field level between payers and providers?  For example, during the review of rejected claims does UnitedHealthcare or any private company such as this have advantages over a healthcare provider compared to what it would be if they were using the regular administrative law judge process?  During the next live edition of Monitor Mondays RACmonitor investigative reporter Edward M. Roche returns to the broadcast to discuss the rights of providers in the two different appeals processes.

Other segments will include these instantly recognizable broadcast segments:

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.
  
  
• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.
  
  
• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.
  
  
• Legislative Update: Cate Brantley, Legislative Analyst for Zelis, will report on current healthcare legislation.

Chapters

• 1:00 Ronald Hirsh, MD
• 4:54 Knicole Emanuel, Esq.
• 8:41 RACmonitor Commercial
• 9:40 David Glaser, Esq.
• 14:33 Cate Brantley
• 18:55 RACmonitor Commercial
• 19:41 Edward M. Roche, PhD, JD
• 24:28 Q&A