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 broke down.
UnitedHealthcare Medicare Advantage plans and health insurance exchange plans are not affected.
The breakdown in talks led to a war of words, with both sides accusing the other of misleading patients.
For its part, Northeast Georgia Health System said it is asking for a “single-digit” rate increase that would put UnitedHealthcare on par with other insurers.
“We remain ready 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.
UnitedHealthcare disputes that claim and blames Northeast Georgia Health System for the impasse.
“NGHS has refused to drop its demands for price increases of more than 20 percent 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 gave a fair and reasonable proposal on March 31 that included significant rate increases,” UnitedHealthcare said in a statement.
The parties have been in negotiations for about six months. Their contract was due to expire on Sunday.
In a statement, Northeast Georgia Health System officials said they don't expect a quick resolution.
“Instead of listening and responding to our requests, United has begun sharing misleading information about the negotiation,” Northeast Georgia Health System said in a special Website created about changes for patients with UnitedHealthcare plans.
About 12,000 Northeast Georgia Health System patients are affected, according to UnitedHealthcare.
Some patients may be eligible 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 recurrent cancer.
The NGHS website lists patient information here. Information is also available by phone at 470-892-3514.
And UnitedHealthcare directs patients to other facilities within the network;
· Emory John Creek Hospital
· Habersham Medical Center
· Northside-Forsyth Hospital
· Northside Gwinnett Medical Center
· Piedmont Eastside Medical Center-Snellville
· Piedmont Mountain
· Piedmont Walton-Monroe Medical Center
· St. Hospital Mary's-Athens
· Union General Hospital
