Here we go again, and this time the hospital contends that United is violating their contract in the fact that giving an imageexclusive to another hospital was not legal.  Parkview will be out of network now for all United Healthcare patients as the hospital basically said you don’t take our Medicare Advantage patients, then you don’t get the rest to include those with employer insurance and others. 

The change doesn’t take place until April of next year so people have time change doctors.  Patients are caught in the middle here but we have been reading quite a bit about all the Medicare Doctors United has fired over the last months with no explanation or communication.

“The Secret Scoring of America’s Physicians” - Algorithmic Math Models For Insurance Network Contractual Exclusions, Relating to MDs Who See Medicare Advantage Patients..

A new Medicare Expansion plan was given exclusively to the other hospital.  The changes will not apply to Supplemental Medicare plans though.  BD 

 


FORT WAYNE, Ind. (WANE) Parkview Health has begun notifying patients that as of April 15, 2015, all services will be considered out-of-network if UnitedHealthcare is their insurance provider.

According to a statement released to NewsChannel 15 by Parkview Health, the move to drop UnitedHealthcare (UHC) stems from a decision by the insurance company to not include Parkview in its new Medicare Advantage plan called AARP Medicare Complete Focus effective January 1, 2015. This means that all services provided by a Parkview Physicians Group physician, specialist, a Parkview hospital or other Parkview healthcare provider will be processed as out-of-network.

On Monday, UHC announced in a press release that Lutheran Health Network would be the preferred provider for enrollees in the Medicare Advantage plan it was rolling out in the Fort Wayne area.

Parkview contends that under contractual terms with UHC, the insurance provider is obligated to include Parkview in the Medicare Advantage plan along with the rest of its offerings.

http://wane.com/2014/10/09/parkview-to-drop-united-healthcare-in-2015/

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