Insurance ‘termination’ note sent to St. Edward patients part of standard procedure

by The City Wire staff ([email protected]) 88 views 

Despite its title, a “Notice of Potential Termination” letter sent by insurance company UnitedHealthcare to thousands of people in the Fort Smith metro area was not intended to cause concern among its customers affiliated with St. Edward Mercy Medical Center.

A letter dated July 1, 2009, was sent by UnitedHealthcare to its insurance customers in the network of Fort Smith-based St. Edward explaining that negotiations between the insurance provider and the hospital have not produced a new agreement and the previous contract expires July 29.

“We assure you we are making every effort to reach a successful resolution. Nevertheless, while we continue our contracting efforts, you may need to make plans if St. Edward’s (sic) Mercy Medical Center becomes an out-of-network provider. Utilizing an out-of-network provider may result in higher costs for you,” noted a section of the UnitedHealthcare letter.

The letter provides customers with a phone number and Web site if they have questions, and also reminds them that Fort Smith-based Sparks Health System is part of the UnitedHealthcare network.

However, UnitedHealthcare spokesman Ron Rollman told The City Wire that “contractual obligations” require such a letter be sent, and that both parties are “very hopeful” an agreement is reached prior to July 29. Rollman said UnitedHealthcare is negotiating directly with the St. Louis-based Sisters of Mercy, the parent organization of St. Edward.

Rollman said it is not unusual for negotiations to “get within the 30-day period” of a contract termination. He also said UnitedHealthcare is “sorry if it (the letter) provides any anxiety.”

Jill McCormick, director of marketing & planning for St. Edward, said the letter from UnitedHealthcare is “standard procedure,” and she also is “hopeful” both sides will reach an agreement.

“Neither party wants a network disruption,” she said.

McCormick said a majority of the hospital’s patients are covered by Blue Cross/Blue Shield, but the loss of UnitedHealthcare “would certainly be an impact for us.”

According to McCormick, St. Edward admits about 14,000 patients a year. The hospital has more than 70 doctors and employs about 1,800.