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Wellmont rejects United Healthcare contract proposal, patients insured by company must switch to keep in-network rates

Staff Reports • Sep 6, 2013 at 8:38 PM

KINGSPORT –– Wellmont Health System announced today that they have rejected a proposal from United Healthcare, which could potentially limit access to hospitals, as well as increase hospital rates for Wellmont patients covered by one of the four United Healthcare insurance plans after Sept. 30.

According to a Wellmont press release, the proposal rejection will affect the insurance company’s four plan’s, which include AARP Medicare Complete Essential, AARP Medicare Complete Plan 2, AARP Medicare Complete Plus Plan 1 and United Healthcare Dual Complete.

Patients wanting to continue to receive in-network rates will need to change insurance carriers.

According to the release, Wellmont patients can switch to BlueCross BlueShield of Tennessee Blue Advantage, Humana, Windsor Health Plan or the federal government’s Medicare program, to retain in-network rates.

Alice Pope, chief financial officer for the health system, said in the release that United Healthcare proposed terms in a new contract that would not allow Wellmont to be “sufficiently reimbursed for costs incurred for care in the system’s hospitals.”

She said the health system would have faced a financial loss if the contract proposal would have gone through.

“Wellmont has negotiated in good faith in an effort to reach agreement on a new contract without a disruption for our patients,” Pope said. “Unfortunately, the result is an unacceptable contract proposal from United Healthcare that does not come close to matching the reasonable amount other insurance carriers pay our health system.”

In the release, Pope said patients that remain insured under United Healthcare will still have access to Wellmont emergency services facilities at in-network rates and physicians in the network and practice at Wellmont hospitals can request this status be granted to their patients.

For more information, patients can call a Wellmont representative at 800-844-2136.

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