All Northeast Georgia Health System locations are now out-of-network for patients with commercial UnitedHealthcare insurance after price negotiations between the insurance giant and the health system recently failed.
UnitedHealthcare Medicare Advantage plans and Health Insurance Exchange plans are not affected.
The breakdown in talks has resulted in a war of words, with both sides accusing the other of misleading patients.
For its part, Northeast Georgia Health System said it’s asking for a “single-digit” rate increase that would make UnitedHealthcare equal with other insurance companies.
“We remain prepared to meet with United, if and when they are ready to be reasonable,” said Steve McNeilly, Chief Operating Officer of Population Health and Vice President of Managed Care Operations for Northeast Georgia Health System in a statement.
UnitedHealthcare disputes this claim and blames Northeast Georgia Health System for the impasse.
“NGHS refused to move off its demands for a more than 20% price hike over the next three years, including a double-digit rate increase in the first year that would make its hospitals the most expensive in Georgia. We provided a fair and reasonable proposal on March 31 that included meaningful rate increases,” UnitedHealthcare said in a statement.
The parties were in negotiations for roughly six months. Their contract expired Sunday.
In a statement, Northeast Georgia Health System officials said they don’t anticipate a speedy resolution.
“Instead of listening and responding to our requests, United has begun sharing misleading information about the negotiation,” Northeast Georgia Health System said on a dedicated website it created about the changes for patients with UnitedHealthcare plans.
Approximately 12,000 Northeast Georgia Health System patients are affected, according to UnitedHealthcare.
Some patients may qualify to continue their care at in-network rates.
This includes people who are pregnant or undergoing an active course of medical treatment, such as for cancer, and patients with newly diagnosed or relapsed cancer.
NGHS’ website lists information for patients here. Information is also available by phone at 470-892-3514.
And UnitedHealthcare is pointing patients to other in-network facilities:
· Emory John Creek Hospital
· Habersham Medical Center
· Northside Hospital-Forsyth
· Northside Gwinnett Medical Center
· Piedmont Eastside Medical Center-Snellville
· Piedmont Mountainside
· Piedmont Walton Medical Center-Monroe
· St. Mary’s Hospital-Athens
· Union General Hospital
