UHC may not be in network with Tennova starting March 1

By Kristi L. Nelson of the Knoxville News Sentinel

As of March 1, Tennova Healthcare hospitals in Knoxville will no longer be in-network for UnitedHealthcare insurance customers, unless the hospital system and insurer reach an agreement about reimbursement rates.

Tennova on Tuesday began sending letters to its patients informing them of the potential change, which affects Physicians Regional Medical Center (the former St. Mary’s), North Knoxville Medical Center, Turkey Creek Medical Center, Jefferson Memorial Hospital, LaFollette Medical Center and Newport Medical Center.

Jerry Askew, vice president of external relations for Tennova, said the health-care company had been negotiating with UnitedHealthcare for more than a year.

“Patients who entrusted us with their medical care should have the option of choosing our hospital for any of their health-care needs,” Askew said. “We continue to negotiate with United to come to a mutual agreement that will allow patients this choice.”

He said Tennova “hopes to have the issue resolved by the end of the month.”

Tracey Lempner, public relations director for the Southeast region at UnitedHealthcare, said Tennova’s for-profit parent company, Franklin-based Community Health Systems, “refused the rate increase we offered for their Knoxville hospitals.”

Lempner said UnitedHealthcare “offered fair rates that are consistent with what other hospitals are paid for their services to ensure Tennova’s continued participation in our network,” and to give policyholders “uninterrupted access to quality care without significantly raising their costs.”

She said about 15,000 UnitedHealthcare commercial and Medicare customers have used Tennova facilities within the past year. Commercial and Medicare plans would be affected, but UnitedHealthcare’s TennCare plan would not, she said.

UnitedHealthcare customers could still use Tennova hospitals but would have to pay higher out-of-network rates that may not count toward deductibles.

Askew said Tennova “has agreements in place with all other major health plans in our area,” including BlueCross BlueShield, Cigna, Aetna and Humana.

UnitedHealthcare members may have access to Tennova hospitals through other networks, including Beech Street, Multiplan and PHCS, said the letter, which urged patients to call United’s sales director to “express your dissatisfaction with their decision.”

UnitedHealthcare and Mercy Health Partners, former owner of Tennova, failed to reach a rate agreement before, in 2010. After Mercy was sold to Florida-based Health Management Associates, HMA and UnitedHealthcare forged a new contract in 2011.

You can read the letter sent to patients at the link below.

PDF: Letter from Tennova to patients



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