To streamline administrative procedures, the UICPG has revised its referral policy. Effective immediately, referral forms should be completed only when you are referring an eligible member outside of the University. The UICPG Medical Director must approve these referrals. Completion of referral forms to another UICPG physician will no longer be needed. This policy is effective immediately and applies to all eligible members who have selected a UICPG as their Primary Care Physician (PCP) and UICPG is responsible for payment of these services. These members belong to the following financial classes:

For members belonging to any other health plan or financial class, you must follow the required referral process of the individual health plan. Questions about this policy and procedural change should be directed to the UICPG Provider Service Representative, Barbara Rabin, at brabin@uic.edu.

Beech Street Corporation has acknowledged that they have erroneously added the UIC Physician Group in their PPO directory without our permission. Because of this, some Beech Street members have sought out medical attention from our physicians with the understanding that these providers were part of Beech Street’s network. This has also caused Beech Street to apply their in-network rates to our claims.

If you find that a discount has been inappropriately taken on a claim, forward that information to Therese Flanagan at Beech Street so the payment can be rectified. Her address is listed below.

Therese Flanagan, Network Development

Beech Street Corporation

Two TransAm Plaza Drive

Suite #400

Oakbrook Terrace, IL 60181

Questions about this issue may be directed to Vince Savackis at savin@uic.edu.

Millions of Americans in employer-based health plans can demand speedier decisions on their health claims and will have more time to appeal rejected coverage under new rules issued by the Labor Department at the end of November.

More than two years in the making, the new regulations, due to take effect in January 2002, are meant to streamline significantly the claims process for persons covered by employer-sponsored health plans, which are governed by the Employee Retirement Income Security Act (ERISA) and generally outside the influence of most other federal regulation.

Under these new regulations, health plans will be required to make coverage decisions within 72 hours for urgent requests, 15 days for preauthorization decisions, and 30 days for services already provided. In addition, plans must notify patients about their claims within 45 days and render decisions within 60 days on appeals of denied claims. Plans currently have up to 90 days to process an initial claim and 60 days to rule on an appeal. Patients will be able to sue health plans if these requirements are not followed.

Patient rights advocated hailed the new rules as long overdue while the American Association of Health Plans and the Health Insurance Association of American reacted by saying that the new rules will lead to increased health costs and unnecessary litigation.

The new regulations will apply to about 130 million employees in the private sectors who receive their health insurance under employer-funded plans.

The cost of employer-sponsored health insurance benefits are expected to rise 11 percent next year and many employers say they will pass on more of the expense to workers, according to a newly released survey by William M. Mercer Inc., a New York-based consulting firm.

This escalation comes on top of health insurance costs that increased 8 percent nationally during the past year. The findings confirmed what many employers and other industry analysts have known: Health insurance costs have been rising steadily over the past three years, largely due to the increased use and cost of prescription drugs.