your insurer’s “secret” provider contract

The Story Behind the Killing of United Healthcare’s CEO
Unmasking our Health Insurance

Your Insurer’s “Secret” Provider Contract

“A Provider Contract defines the business relationship between healthcare providers and insurers” – – – And yet: 1.) The only two Congressional Reports on the structure of the U.S. healthcare system state only that the “contracts be in writing” and if the insurer “fails to pay for services, the subscriber is not to be billed,” 2.) In 2005 the states agreed the “contracts shall be treated as trade secrets,” 3.) That same year the AMA told the nation’s doctors to look “solely to the insurer for payment” and 4.) There are more than two dozen consulting companies dedicated to helping doctors and hospitals understand these Provider Agreements/Contracts — but, not a single one to help you and me understand the rights they give us, let alone to even know of their existence.

Now, I ask you, can it be any clearer that the American Healthcare System doesn’t want us to know what’s in these SECRET Provider Agreements/Contracts? Can it be any clearer that when an in-network doctor or hospital claims they can’t give us the care we need because our insurer his denying coverage, that they are knowingly ignoring their contractual requirement to provide the care regardless of whether it’s covered by the insurer? And, can it be any clearer that when an in-network doctor or hospital bills you for what your insurer fails to pay, that they are blatantly ignoring their contractual ban on billing you? All made possible because you can’t know what you don’t know. Meaning, we can’t claim the rights these SECRET Contracts give us, if we are kept from knowing the Contracts even exist. Leaving far too many patients and families lost in a bewildering fog of delayed and denied healthcare along with their Siamese-twin the all-to-common “bankruptcy inducing healthcare bill” (CFPB).

If we were talking about anything other than health insurance, we would not only have a right to know of the existence of the Contracts, but the right to understand the rights that they create for us. But not here! Not when it comes to understanding the rights that we are entitled to receive from our health insurance. And, certainly not when every state in the country has ruled that the Contracts are to be treated as “proprietary confidential documents” that must to be kept SECRTE and undisclosed.

The rights that these SECRET Contracts afford us are defined as “Third-party Rights, and best understood as simply the rights that are established when two parties contract to provide compensation to protect a third party from a loss or expense — we being the Third-party and the two contracting parties being our insurer and their in-network provider.

So, we are being asked to “trust” our healthcare insurance company to deliver the care and financial protection that we are owed from a Contract we are not allowed to see, and rights that will NERVER be disclosed. Simply put, we are asked to have BLIND faith in an insurer that literally holds the key to our very life and our financial wellbeing. BLIND faith in an insurer and insurance industry that daily demonstrate a far greater dedication to profit, executive bonuses and the investment community than the needs of the people it insurers.

The bottom line is that everything we think we know about health insurance is intentionally misrepresented and dead-flat wrong. Leading to a host of people across the country who have been damaged in both life and for life — and they are angry, very angry! The old line of, “it’s just business” may work for the Mafia, but it isn’t going to work for the people who have had their lives destroyed.

Unlike the horror story of this person or that person having been denied critical healthcare, or forced into bankruptcy by an unpaid bill, the killing of United Healthcare CEO Brian Thomas isn’t going away anytime soon. Not unless the trial of the shooter somehow proves unnecessary. No, the far more likely course is that the attorney for Luigi Mangione will insist on introducing his state of mind at the time of the shooting. Which promises to be the far bigger story, i.e., the story behind the shooting. A likelihood now amplified by a shareholder request for a study into the policy and practices of United Healthcare leading up to the shooting, and the countless articles and reports on the rage and glee that has accompanied the shooting.

See the Reuters December 9, 2024 article stating that the killing of United Healthcare CEO Brian Thompson “has ignited an outpouring of anger from Americans struggling to receive and pay for medical care.” – – – The far bigger story behind the New York shooting and the focus of our future posts.

And lastly, please follow our future posts as do our very best to bring to you the far bigger story of what the insurance industry is desperately trying to hide.

Go to www.killAbill.com for more on what your insurer is hiding.

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