A group of UnitedHealthcare patients have found themselves in the middle of an anesthesiology fight.
Novant Health has an exclusive contract with Providence Anesthesiology Associates to handle all of its anesthesiology in Charlotte.
Providence has been independent, locally owned group of nurses, physician assistants and physicians in Charlotte for more than 40 years.
UnitedHealthcare used to cover Providence in-network, but the two had a falling out last year. They’ve been trying to work out a deal ever since.
So, if you have United and undergo surgery at Novant in Charlotte, you don’t have any in-network anesthesiologists to choose from.
Providence told Action 9′s Jason Stoogenke it’s “fiercely opposed to the unilateral change in reimbursement UnitedHealthcare initiated by unexpectedly dropping us from their provider network last year. We’re one of numerous specialty practices throughout North Carolina and across the country that United has removed in an effort to increase their profits at the expense of patients. Providence is fighting on behalf of these patients by filing appeals with United and claims with the North Carolina Department of Insurance, and all our patients should know that we’re not asking for any payments until each individual situation is resolved.”
Providence said about 95% of patients with United haven’t had to pay anything so far.
Novant says it’s “working to ensure our impacted patients are notified of the changes prior to a procedure as best we can. We understand Providence Anesthesiology Associates is also doing what it can to ensure patients are not burdened with higher-than-expected charges for their services.”
“Unfortunately, the impasse in negotiations between UHC and PAA has our patients stuck in the middle. UHC must resume negotiations, now, and work with PAA to find a reasonable solution,” it added.
“Under all circumstances, it’s imperative patients feel empowered to confirm with their insurance provider what is in-network by facility – and also by physician. We have a team of financial navigators who are available to help patients better understand their health care expenses, including what questions to ask of their insurance provider prior to a procedure,” it went on to say.
“While we’re working diligently within our contract with PAA on a resolution, we continue to share our patients’ concerns and frustrations,” it told Stoogenke.
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United told Stoogenke, “Exorbitant surprise bills are stressful for patients and drive up the cost of health care for everyone. That’s why Congress passed legislation that will prohibit providers from surprise billing their patients starting in 2022. What’s most important for our members to know is that they should contact us if they receive a surprise bill from Providence. We will work directly with Providence to negotiate a reasonable reimbursement rate to help protect our members from being held responsible for paying the bill.”
“We strongly encourage our members in North Carolina who have a surgery or procedure scheduled to call the number on the back of their health plan ID card and speak to a member of our customer care team. Our customer care advocates can help them understand how to mitigate the risk of paying higher out-of-pocket costs for the anesthesia services they need and direct them to a participating hospital with in-network anesthesia services,” it added.
If you have United and got a bill you weren’t expecting, call Providence (704-749-5801) and United (use the number on the back of your card) before you pay it.