Healthcare Advocate Saves Consumers $5.7 Million In 2010

HARTFORD — Victoria Veltri, acting state healthcare advocate, announced January 10 that the Office of the Healthcare Advocate (OHA), the independent state agency that assists consumers with managed care insurance issues, generated $5.7 million in savings for Connecticut health care consumers in calendar year 2010. 

The savings figure of $5.7 million represents the costs of health care services, procedures, and claims that would have been borne directly by consumers of health care, had the agency not intervened.

In 2010 OHA received many inquires from consumers with questions about how to get or keep their insurance and understand changes due to federal health care reform.  These calls were in addition to the many complicated appeals the office handled. 

“The cases we are opening are complex,” Ms Veltri said. “We save so much for consumers because OHA staff does not quit on any case until every source of coverage is exhausted, and every possible remedy is explored.  When we open a case, we are with patients and their families for the long-haul.”

OHA prides itself on real-time services for health care consumers. 

“The real-time services we offer can be the difference between a consumer receiving necessary and appropriate care and going without care, which can lead to serious consequences,” Ms Veltri said.

The $5.7 million savings in 2010 clearly represents to the OHA staff’s hard work, but also suggests a lot of work still left to do in helping people with their managed care appeals and in shaping the system.

“The demand for our services keeps increasing. We also expect a surge in caseload this year; a new state law requires insurers to provide OHA’s contact information on denial notices, so that consumers can have easy access to our free and effective services,” said Ms Veltri.

She added that the office remains a model of efficiency and a bargain in state government. 

“With a less than $1 million budget, we’ve paid for ourselves nearly six times over, but the real story is that we hold managed care organizations accountable for their coverage decisions.”  

At the same time, OHA continues to be a premier resource for Connecticut’s federal delegation on health care issues.

Ms Veltri believes that a major goal for 2011 is to get the message to health insurance consumers about their new health care rights under federal health care reform and to remind them that they can turn to OHA if they need help. 

OHA will continue to intervene in cases where more systemic advocacy is needed, including the pursuit of an aggressive legislative agenda to curb excessive rate increases and to ensure meaningful access to healthcare to all residents.

For free assistance, consumers can call 866-466-4446 or e-mail OHA at healthcare.advocate@ct.gov. 

For general information, Ms Veltri recommends that consumers visit OHA’s website at www.ct.gov/oha.