Healthcare Advocate Recovers $3.3M For Consumers In First Quarter

HARTFORD — Victoria Veltri, Acting State Healthcare Advocate, announced that the Office of the Healthcare Advocate (OHA), the independent state agency that assists consumers with managed care insurance issues, generated $3.3 million in savings for Connecticut health care consumers in the first quarter of 2011. The savings figure of $3.3 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.

The $3.3 million figure is a record for quarterly savings by OHA and represents the recovery of expenses on multiple, complex cases. OHA also experienced a record quarter in number of cases received, at 760, while closing 656 cases.

Ms Veltri explained that the surge in case load is due to two things: a state law that requires insurers to provide OHA’s contact information on denial notices and a federal grant under which OHA is providing extensive outreach and education on individual’s rights under the Affordable Care Act and OHA’s availability to assist consumers with health insurance matters.

In the first quarter of 2011, 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. Ms Veltri said, “The cases we are opening are complex. OHA staff does not quit on any case until every source of coverage is exhausted, and every possible remedy is explored. When we open cases, we are with a patient and 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.

She added, “OHA will continue to pursue its major goals for 2011 — to get the message to health insurance consumers about their new health care rights under federal healthcare reform and to remind them that they can turn to OHA if they need help with their insurance questions or problems.”

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.