Page 2 - Boca ViewPointe - September '19
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Page 2, Viewpointe September 2019
Boca Raton Hospital – UnitedHealthcare Update
No News Is Bad News doctors and patients to accommodate
new elective UnitedHealthcare cases
By Arthur Dermer, Volunteer at one of the nearby in-network
Baptist Health South Florida
During the past TWO facilities in the United Healthcare
MONTHS there have been network. (Bethesda Medical Center
numerous media reports in Boynton is one of 9 such hospitals
regarding the Boca Raton in that network).
Regional Hospital’s contract You should be aware that the
with UnitedHealthcare. That Hospital is encouraging United
contract expired June 30, Healthcare patients to stay in touch
2019. On July 1, 2019 the with their doctors. As of July 1,
Boca Raton Regional Hospital 2019, ALL United Healthcare
became part of the Baptist plans (except United’s Medicare Boca Raton Regional Hospital
Health System. You should Supplemental plans) are out of
be aware that BAPTIST HEALTH SOUTH FLORIDA is network with Boca Raton Regional Hospital. The plans supplementary plans) are out of network. The plans that are
the partner and lead negotiator for Boca Regional Hospital that are out of network with Boca Raton Regional Hospital out of network include all commercial Medicare plans. If this
in its dealings with United Healthcare. It is working with include almost all commercial plans. If this sounds confusing sounds confusing contact UnitedHealthcare for clarification.
United Healthcare to reach a resolution of a conflict that has I recommend you contact your local providers to insure that Question: Will your physician’s participation status
been ongoing for the past few months. There is very deep you receive the most up-to-date answers to your important with United Healthcare be affected? I have been told that at
concern, anger and fear among many residents of Boca Pointe questions. this time there have been no changes. However, should you
regarding the unsettled contract between Baptist Health and Patients covered by United Healthcare who were in the have any questions about your doctor’s participation with
United Healthcare. To that point I have received over 30 hospital prior to June 30 or who are in rehabilitation or UnitedHealthcare you should contact your doctor directly
calls in the last few weeks regarding this troubling situation. midway through their treatment plan should be aware of the for more information.
As someone who has been involved with the hospital as a following: Boca Raton Regional Hospital has had a long-standing
volunteer for almost 20 years, I want to try to clarify recent If you have already started to receive care at the hospital relationship with United Healthcare. It was working
events so that you may have a better understanding of what you may be allowed to complete your scheduled care if you diligently to reach a new agreement. Residents should,
is transpiring. fall into one of the following categories: however, be aware that since July 1, it is Baptist Health South
At the present time, there has been NO FINAL 1. receiving prenatal care during any trimester. Florida which is responsible for negotiations with United
RESOLUTION of the economic discussions going on 2. currently receiving radiation or chemotherapy for Healthcare. The timing for reaching a resolution is unknown
between the two groups (Baptist and United). Monetarily, the cancer. at this moment. If the services of a hospital is important to you
two sides are far apart in the negotiations. No compromise 3. currently undergoing a staged surgery for example and your health care needs, you are encouraged to consider
seems to be within reach in the immediate future. To help you breast reconstruction. choosing a plan that includes Boca Raton Regional Hospital
better understand the disturbing situation, I will try to clear up 4. if you were admitted for medically necessary services as an in-network provider at your next open enrollment. A list
some of the major concerns people have. To that end I have before July 1, 2019 and will not be discharged until after that of the Hospital’s accepted insurance plans can be obtained
had discussions with Jerry Fedele, former President and CEO date. at the hospital insurance offices.
of the Hospital, Lincoln Mendez, newly appointed President In all cases you should contact UnitedHealthcare before The Boca Community as always been a major supporter
of the Hospital and Mark Larkin, President of the Hospital treatment to make sure your needed services are covered. You and fund raiser for the hospital. However, there is a great
Foundation. I believe that these men have been working can call the telephone number on the back of your United deal of uncertainty and fear among our residents that what
diligently to get this matter settled as soon as possible. healthcare member ID card. You may also need to contact they have always thought would be available to them might
In an effort to keep you as informed, here are some of the United Healthcare’s Medical Management department with be taken away at an age when they need it the most. They
most frequently asked questions about the ongoing situation. questions about your continuity of care benefit coverage. fear losing their doctors and being denied the services which
Please be aware that negotiations are in flux and the situation Question: What about emergency room services? With the hospital provides.
can change at any time. Be aware that these are complex regard to emergency services, be aware that all emergency We hope that the Baptist Health and United Healthcare
matters so that there may be more intricate details other than services will continue to be covered by the patient’s insurance can quickly resolve their differences and put an end to the
those shown. plan regardless of whether the plan is in network or out of confusion, concern and anxiety of our residents. Two months
Question: Is Boca Raton Hospital still accepting United network with the provider. In addition, patients who have out seems like it should be enough time for responsible people
Healthcare as a supplemental insurance to regular Medicare? of network benefits coverage can choose to receive elective to reach a settlement. If you need any clarification regarding
YES. The hospital still accepts United Healthcare Medicare services at the hospital although they may experience higher this situation you can call United Health. Hopefully all will
supplements to traditional Medicare policies. If you are a cost-sharing for out-of-network providers. be settled by the next issue of Viewpointe. How much more
Medicare patient, you should not be concerned regarding Question: Which United Healthcare plans are affected time will it take to reach a settlement? I have no idea nor
this matter. There are no changes affecting you. by these negotiations? As of July 1, 2019, almost all United do I have any inside information. However, be assured that
Question: If you see a doctor who is affiliated with the Healthcare plans (except UnitedHealthcare as Medicare updates of this situation will follow as they occur.
hospital will they still be taking United Healthcare? Are the
tests or procedures done at the hospital affected? Are there
certain United Healthcare policies that the hospital still takes?
Boca Care doctors and Boca Raton Regional Hospital
Urgent Care Centers remain in network with United
Healthcare at this time. However, Boca Raton Regional
Hospital and Boca Raton Regional Hospital’s Outpatient
Diagnostic Imaging Centers are out of network with United
healthcare as of July 1, 2019. After July 1, 2019 United
Healthcare will likely not authorize new elective services at
the hospital that are not part of an ongoing continuation of
care. Therefore be aware that the Hospital is working with
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