Medical Center, United Health Care at Odds Over Contract

11:54 AM, Jul 19, 2010   |    comments
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If you're a Bibb County school employee, or a state employee, getting treated at the Medical Center of Central Georgia will probably cost you more.

That's because the hospital's contract with a major insurance company, United Health Care, expired June 30.

Has the expired contract affected you and your family? If so, we'd like to hear from you. Please send an e-mail to: eyewitnessnews@13wmaz.com.

 

In a letter, Medical Center president Don Faulk notified patients that United Health Care will no longer provide "in-network" coverage for most customers.

In the letter, Faulk blamed the insurance provider for not being able to come to a contract agreement, saying "it is very distressing that an insurance company can be so unconcerned about honoring its own contracts, blame others, and then leave the patients to fend for themselves."

Medical Center spokeswoman Janie Poulnott said hospital officials could not speak to 13 WMAZ Friday. United Health Care did not return our phone calls.

Although the details will vary depending on your health plan, that means many people who want to be treated at the Medical Center will have to pay more.

To find how this may affect you, the Medical Center says they've set up a hot line to answer questions about your coverage. You can reach the hospital's customer service at 478-633-1130.

The Bibb County school district sent a letter to all employees this week, notifying them of the changes.

The school district's letter says:

 "If you have United PPO or Open Access coverage, you may still use the MCCG for the care you need, but you will be required to pay higher out-of-pocket costs.

 "If you have United HMO coverage, you will have "in-network" access through the emergency room ONLY. United will require you to pay for all non-emergency room care at the MCCG out of your own pocket."

 Last month, the Medical Center told the public that their contract with United Health Care was about to expire.

 A June 2 letter from hospital CEO Don Faulk said, "This situation has arisen because United failed to honor its contract obligations to MCCG under its provider agreement for many months, refused to correct ongoing reimbursement errors, opposed dispute resolution on an expedited basis to resolve our issues quickly, and announced without any advance notice to MCCG that the agreement will terminate on June 30, 2010."

 The dropped contract also affects many state employees in Central Georgia.

 The letter says:

 EMPLOYEES WITH UNITED HEALTH CARE (UHC)

The school district has been notified that as of 6/30/2010 the Medical Center will no longer provide "in-network" coverage for those employees enrolled with United Health Care. You may have received a letter from UHC or the Medical Center of Central Georgia (MCCG) and we want to be sure you know what has occurred and how this has affected you and anyone else covered under your insurance.

The situation arose because United Health Care failed to honor its contract obligations to the MCCG under its provider agreement and announced without any advance notice to the MCCG that the agreement would terminate on June 30, 2010. Unfortunately, this situation is out of the control of the Bibb County School System or any other school system that uses the MCCG. This is also out of the control of the State Health Benefit Plan. This decision is completely between the Medical Center of Central Georgia and United Health Care.

If you have United PPO or Open Access coverage, you may still use the MCCG for the care you need, but you will be required to pay higher out-of-pocket costs.

If you have United HMO coverage, you will have "in-network" access through the emergency room ONLY. United will require you to pay for all non-emergency room care at the MCCG out of your own pocket.

Should we receive notification from the State Health Benefit Plan of any changes between both the Medical Center of Central Georgia and United Health Care, our Benefits Department will immediately notify all of our employees.
 

 

 

 

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