Page 8 - Boca ViewPointe - August '19

Page 8, Viewpointe August 2019

UnitedHealthcare Update from page 1 Question: Which
UnitedHealthcare plans
In an effort to keep you as informed as possible, here are affected by these
are some of the most frequently asked questions about the negotiations? As of
ongoing situation. Please be aware that negotiations are July 1, 2019, almost all
in flux and the situation can change at any time. Also be UnitedHealthcare plans
aware that these are complex matters so that there may (except UnitedHealthcare
be more intricate details other than those shown. as Medicare
Question: Is Boca Raton Hospital still accepting supplementary plans) are
UnitedHealthcare as a supplemental insurance to out of network. The plans
regular Medicare? YES The hospital still accepts that are out of network
UnitedHealthcare Medicare supplements to traditional include all commercial
Medicare policies. If you are a Medicare patient, you Medicare plans. If this
should not be concerned regarding this matter. There are sounds confusing contact
no changes affecting you. UnitedHealthcare for
Question: If you see a doctor who is affiliated with the clarification.
hospital will they still be taking UnitedHealthcare? Are Q ue sti on: W i l l
the tests or procedures done at the hospital affected? Are your physic i a n’ s Boca Raton Regional Hospital
there certain UnitedHealthcare policies that the hospital participation status with
still takes? UnitedHealthcare be affected? I have been told that at that includes Boca Raton Regional Hospital as an in-
Boca Care doctors and Boca Raton Regional this time there have been no changes. However, should network provider at your next open enrollment. A list of
Hospital Urgent Care Centers remain in network with you have any questions about your doctor’s participation the Hospital’s accepted insurance plans can be obtained
UnitedHealthcare at this time. However, Boca Raton with UnitedHealthcare you should contact your doctor at the hospital insurance offices.
Regional Hospital and Boca Raton Regional Hospital’s directly for more information. The Boca Community as always been a major
Outpatient Diagnostic Imaging Centers are out of network Boca Raton Regional Hospital has had a long-standing supporter and fundraiser for the hospital. There is a
with UnitedHealthcare as of July 1, 2019. After July 1, relationship with UnitedHealthcare. It was working great deal of uncertainty and fear among our residents
2019 UnitedHealthcare will likely not authorize new diligently to reach a new agreement. Residents should, that what they have always thought would be available
elective services at the hospital that are not part of an however, be aware that since July 1 it is Baptist Health to them might be taken away at an age when they need it
ongoing continuation of care. Therefore be aware that South Florida which is responsible for negotiations with the most. They fear losing their doctors and being denied
the Hospital is working with doctors and patients to UnitedHealthcare. However, the timing for reaching a the services which the hospital provides.
accommodate new elective UnitedHealthcare cases at one resolution is unknown at this moment. If the services We hope that the Baptist and UnitedHealthcare can
of the nearby in-network Baptist Health South Florida of a hospital is important to you and your health care quickly resolve their differences and put an end to the
facilities in the UnitedHealthcare network. (Bethesda needs, you are encouraged to consider choosing a plan confusion, concern and anxiety of our residents. 
Medical Center in Boynton is one of 9 such hospitals in
that network).
You should be aware that the Hospital is encouraging
UnitedHealthcare patients to stay in touch with their
doctors. As of July 1, 2019 ALL UnitedHealthcare plans
(except United’s Medicare Supplemental plans) are out
of network with Boca Raton Regional Hospital. The
plans that are out of network with Boca Raton Regional
Hospital include almost all commercial plans. If this
sounds confusing I recommend you contact your local
providers to insure that you receive the most up-to-date
answers to your important questions.
Patients covered by UnitedHealthcare who were in
the hospital prior to June 30 or who are in rehabilitation
or midway through their treatment plan should be aware
of the following:
If you have already started to receive care at the
hospital you may be allowed to complete your scheduled
care if you fall into one of the following categories:
1. receiving prenatal care during any trimester.
2. currently receiving radiation or chemotherapy for
cancer.
3. currently undergoing a staged surgery for example
breast reconstruction.
4. if you were admitted for medically necessary
services before July 1, 2019 and who will not be
discharged until after that date.
In all cases you should contact UnitedHealthcare Norbert Graber, R. Ph.
before treatment to make sure your needed services are and Lynn Graber, R. Ph.
covered. You can call the telephone number on the back
of your UnitedHealthcare member ID card. You may also
need to contact UnitedHealthcare’s Medical Management
department with questions about your continuity of care
benefit coverage.
Question: What about emergency room services?
With regard to emergency services, be aware that all
emergency services will continue to be covered by the
patient’s insurance plan regardless of whether the plan
is in network or out of network with the provider. In
addition, patients who have out of network benefits
coverage can chose to receive elective services at the
hospital although they may experience higher cost-
sharing for out-of-network providers.

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