Patients caught in contract dispute between CaroMont and UnitedHealthcare

CHARLOTTE — A contract dispute between a regional healthcare provider and an insurance company could leave many patients scrambling to find new options.

CaroMont Health and UnitedHealthcare are having trouble coming to terms on a new contract, and that’ll have big impact if there’s no deal in the next few months. Here’s what would happen: First, patients who get United specifically through their employer and use any of the CaroMont facilities listed below, you’ll have to pay out-of-network prices for everything you have done there, or you’ll have to switch doctors.

Affected CaroMont Facilities:

  • Regional Medical Center
  • Regional Medical Center-Mount Holly
  • Cancer Center
  • Lincoln Cancer Center
  • Outpatient Surgery
  • A few others

The contract dispute won’t impact you if you have a different United plan, are a Medicare Advantage member, or use any of CaroMont’s other facilities.

But the dispute is leaving patients like Leanne Mason caught in the middle.

“I was upset,” Mason told Action 9′s Jason Stoogenke. “It’s a hassle.”

Nothing has changed yet. The entire CaroMont system is still in-network and will be until at least April 1, 2023.

Action 9 reached out to CaroMont and UnitedHealthcare for answers about the dispute. Both companies sent statements to Stoogenke.

“For more than two years, CaroMont Health has tried in earnest to establish a long-term agreement with UnitedHealthcare. Unfortunately, UnitedHealthcare is unyielding in their position that CaroMont Health accept reimbursement rates that are lower than those accepted by other insurers and received by other hospitals and health systems in the region. At this time, it appears UnitedHealthcare will not compromise. This means beginning on April 1, 2023, care received at CaroMont Health facilities will be considered out-of-network for UnitedHealthcare plans,” said a statement from CaroMont. “While we are deeply disappointed by this outcome, we remain committed to finding solutions that allow all patients who wish to visit a CaroMont Health facility to receive exceptional care at in-network rates. If patients are concerned about this situation, they may contact their Human Resources department or Benefits Administrator and ask them to encourage UnitedHealthcare to extend the agreement with CaroMont Health or consider choosing another health benefit plan that includes CaroMont Health in the provider network.”

United Healthcare sent the following statement: “We’re disappointed CaroMont is mischaracterizing our negotiation and is creating unnecessary anxiety for the people we mutually serve. We are very early on in our contract discussions and are committed to continued good-faith negotiation over the next six months. Our goal is to renew our contract and avoid disruption. We hope CaroMont shares our commitment to reaching an agreement that is affordable for North Carolina residents and employers.”

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