Wednesday, November 4, 2009

Connecticut Health Care Advocate Announces $2.7 Million in Savings

Connecticut Health Care Advocate Kevin Lembo announced Wednesday that his office saved consumers $ 2.7 million through the third quarter of 2009.

The office saved $700,000 for consumers in the third quarter alone, officials said.

“Our office continues to provide the most cost-effective consumer assistance on health insurance issues in the state of Connecticut ," Lembo said. "The diligent staff, their dedication and personal attention to consumers and their perseverance make a difference.”

While OHA does not measure the success of its efforts solely in consumer dollars saved—the office has a legislative policy function and works on state and federal health care issues that impact Connecticut’s health care consumers—the amount saved for consumers is an indicator of the level of demand for and success of OHA’s intervention.

Referrals to the Office of the Health Care Advocate come from previous satisfied consumers of OHA services who go on to refer a friend or family member. So far this year, OHA has worked on 2,476 cases, and projects a 50% year-end increase in cases over 2008, Lembo said.

“The true measure of our value comes from the repeat referrals we get from providers, legislators and consumers who come away very happy with and thankful for our efforts ," he said. "We don’t win every case, but consumers know that when they come to OHA we exhaust all avenues to address their concerns.”

Lembo expects the demand for the office’s individual case work to rise pending substantive health care reform: “We are committed to bringing back to the legislature our long-advocated changes in state law on utilization review, as well as our initiative on post-claims underwriting, which protect consumers from unfair denials of coverage and rescission of their insurance policies. These reforms are long overdue. It is long past time that the playing field is leveled to give patients and their families a fair shot when they go to battle with their insurer.”

Last year the office saved consumers over $5.2 million in denied claims or services by health insurance companies that were ultimately reversed in the consumers favor.

Consumers who are experiencing difficulties in getting needed health care, whether it’s the inability to find a provider or the denial of medical or mental health or dental treatment, may call OHA at 1-866-466-4446 for free and confidential expert assistance.

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