FOS Looking into Reports of Trouble with Universal Health Care Medicare HMO

The Florida Orthopaedic Society has received information concerning reimbursement and authorization hassles with Universal Health Care's Medicare HMO and Any, Any, Any Plan.  We are currently trying to gather additional information from our members on similar experiences.  If you have any concerns about the claims handling or authorization process at Universal, please contact the FOS office at 813-948-8660.

Comments

[Stuart D. Patterson]

I have had serious issues with Universal. The company no longer contracts with my primary admission hospital, Heart of Florida Regional Medical Center. My secondary hospital (Bartow Regional Medical Center) has terminated their contract with Universal effective March 1st, 2007. They are taking in excess of two months to pay claims. I have a Universal patient who was referred to Moffitt Cancer Center for management of a sarcoma. He was approved to begin treatment and underwent chemo and radiotherapy. He is scheduled for resection of the sarcoma and now Universal have denied him further treatment at Moffitt. I have another Universal patient who attended the Lakeland Reg Med Center ER with a hand laceration. He was referred to Watson Clinic and turned away as they do not accept Universal. He was seen in my office and noted to have a digital nerve laceration. I can only do micro at Heart of Florida Regional Med Ctr HOFRMC) that is no longer participating. Universal has no other listed participating hand surgeon in Polk County. On contacting Universal with respect to this, they told my office it was my responsibility to find an alternative surgeon and told the patient that it was his problem to take care of. After contacting Dr. Sewell their medical director, we were able to get him taken care of at HOFRMC after numerous calls and an entire working day of my practice administrator being taken up by this. The entire experience has resulted in my refusal to see any new Universal patients. My experience appears to be typical for other physicians in this area. This is a very difficult company to work with. One wonders whether the conduct of the Medical Director can be reported to the FL Board of Medicine.