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Consumers Save $9.5M Wtih Help of Healthcare Advocate

by Hugh McQuaid | Jan 9, 2014 6:30am
(2) Comments | Commenting has expired
Posted to: Health Care

CTNJ file photo

State Healthcare Advocate Victoria Veltri

Last year, the Office of the Health Care Advocate helped more than 5,600 Connecticut consumers and saved them a total of $9.55 million, according to statistics from state Healthcare Advocate Victoria Veltri.

The savings are costs consumers would have had to pay in claims for medical services and procedures if the office had not intervened, according to a press release. The office assisted 5,683 residents with issues like denials of medical coverage and unwarranted billings.

Veltri said the office worked to offer effective services to each of the consumers that reached out for help in 2013.

“OHA staff helped parents secure coverage for their babies’ lifesaving treatment, overturned denials of coverage, or corrected errors that prevented children and adults from getting necessary mental health and substance use treatment, physical, speech and ABA therapy, neurological evaluations, urgent chemotherapy, and surgical interventions,” she said. “The staff handled thousands of calls from consumers who needed answers to questions about their healthcare coverage policies.”

Last year, the office helped negotiate behavioral health care reforms included in the legislative response to the Sandy Hook shooting. It also partnered with the state’s healthcare exchange on outreach programs designed to encourage residents to enroll in health care coverage.

The new law requires mental health and substance abuse services to be considered “urgent care” and shortens the review time for service requests from 72 hours to 24 hours. It also requires insurance companies to inform consumers that they have the right to appeal a denial of care; the Insurance Department to evaluate and report on compliance with mental health parity laws, and the health professional reviewing an insurance claim to have similar qualifications to the medical professional prescribing it.

“OHA is involved in every facet of health reform in Connecticut.  While we advocated for consumers in each of the individual cases, we participated in or led systemic health reform efforts that will shape Connecticut’s healthcare future, one in which we will knock down barriers to access to high-quality, affordable, medically necessary healthcare,” Veltri said.

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(2) Comments

posted by: Noteworthy | January 9, 2014  9:37am

The OHA is one of the great under appreciated agencies in state government. It more than pays for itself by real time cost savings to consumers and it provides legal and moral support at the very time when we are most vulnerable. Other state agencies would do well to follow their recipe by putting consumers (us) first. The OHA’s non-stop efforts to bring parity to mental healthcare has resulted in people with significant problems getting help and the type of help they really need, help that the insurance companies deny or diminish.

posted by: Zilla63 | February 7, 2014  10:59pm

If you believe 5% of that, I have a bridge…No way.  Time for Results Based Accountability to visit OHA.