I got a call at my office today from our insurance rep and she said that in the event of an emergency, United Healthcare would honor a visit to WakeMed, under out of network. If given a choice, choose one of the other ER's, but in the event you can't make the choice or aren't allowed to, they will honor everything.
We have United Healthcare and have not heard anything from them on this change. The news article does say you can use the WakeMed hospital and WakeMed drs out-of-network BUT that would cost more out of pocket.
It took quite a while for our doctor's office to accept United Healthcare insurance b/c they told us they were having a hard time negotiating with them. They said UHC didn't want to pay anything for the care the doctors were providing. I guess they finally worked it out, but I do remember the doctor telling us how hard they were to deal with. Thankfully we don't have that insurance anymore. I mean, what's to stop them from doing this with all the other hospitals? They are trying to bully the hospitals into changing their rates. IMO, the rate should be the same for everyone, no matter who you have insurance with, not who was the better negotiator when it was contract time.
I wonder how United Heathcare can get away with charging companies (clients) a specific fee for the insurance coverage then drastically decrease the amount of doctors and hospital options. The companies (clients) should be asking for a decrease in the fees they pay to UHC since the level of service options for the customer is now less.
My company uses their crappy a** and I wish they would go back to Aetna, but I don't see that happening. Hopefully my doctor isn't with them.. I better check and find out
We've had UHC for 6.5 years and I have been pleased with our options and coverage. Mostly I like that we don't have to get referrals to see a specialist. Prior to UNC we were self-insured through Blue Cross which was EXPENSIVE, limited and had a lot of out of pocket expenses.
United and WakeMed were not negociating a new contract, they were half way thru a 3 year contract when United pulled this crap. Wake Med has a "careline", call them at 350-8000 if you have United, and they will transfer you to the careline. What WakeMed is doing for people with out-of -network coverage is waiving the difference between in-network and out-of-network costs, but it must be preapproved thru the careline. Therefore, it will not cost you any more to go to WakeMed. It is acctually cheaper for the hospital than accepting the lower amount United wanted to re-negociate halfway thru their contract. Sorry for the spelling, in a rush.
What would be even better is if hospitals and doctors charged reasonable rates for the services offered. If they did that I don't think the insurance companies would have so much to complain about or would be so hesitant to pay. Last Oct. I had knee surgery performed at Rex. Paid $200 up front when I walked in the door before they would even start my paperwork. Said that was all I would have to pay, and that the rest would be covered by insurance. Got a bill from them two months ago, saying that insurance had paid x amount and that I still owed them $1100. Upon checking into it the insurance covered all but 20%, which leaves me end up paying $1300 total to the hospital for roughly a 2 hour visit. Which means the total bill for that roughly 2 hour visit works out to be roughly $6500. Mean while the actual Dr.'s bill is $192.00 And he spent roughly 20-25 minutes performing the surgery. So do the math on that one. BTW...for what it's worth my knee felt great up till the cold weather started moving in, now it aches like the devil. Craig
Insurance is all a scam!!! When we had our son we had BCBS. We were on a 80-20 plan so I paid the 20% we were going to owe to the OB over the 9 months my wife was pregnant. When she had our son, the day after we got home we received a bill from Wake Med that said pay us now or we will send you to collections. Well as it turns out the OB my wife went to was "affiliated" with Wake MEd. We reached our yearly out-of-pocket maximum and as the bills started rolling in I noticed that the 20% I already paid the OB was paid again by the Insurance. I called and discussed the matter with Wake Med and my insurance company and got "we will have to ivestigate the matter, it will take about 2-3 months to get a refund if you are supposed to get one" I told them they had 2 weeks (more than they gave me) to get me a refund or I was sending thier a** to collections. I did get the money back but do you think they would have ever sent it back if I had not been scrutinizing the bills? Heck No!!!!
dayam I am glad we just switch from United!! Not that we go to the hospital every other day. But that is the hospital my kid's docs admit to. Sheesh!! United has gotten a bit out of hand here lately. For the past 2 years our premiums have gone up AT LEAST 50% for my CO each year. Which is just plain NUTS! Insurance is a scam!!
Crap. Gotta call the Peds. That's their hospital. I wonder if the peds accepts it still. That would be just g-r-e-a-t for them to drop United 2 months into a year, and we cannot change until next January :evil: . Frogger
Update: Garner/Raleigh Peds still takes United Healthcare. They also go to Rex, so the kids can go there instead of WakeMed. Frogger
UHC health coverage We have UHC here at work. The way it was explained at our meeting is that UHC has what they call an "evergreen" contract - that means it is a lifetime contract and that either party can renegotiate the terms as long as they give 90 days notice. From what I understand UHC requested the renegotiation after they found out that the other insurance companies were paying out less for the same service that UHC was paying more for. Can't blame UHC there.
I never knew they gave bulk discounts on medical care! I thought that's what they were saying in the N&O, that BCBS gets lower rates because they bring in more business, but I didn't think that could be right. Live & learn.
You should see the discount rates they give on Medicaid and Medicare. Lots of insurance companies have heartburn about those!!
UnitedHealthcare, Wake Radiology end partnership http://rdu.news14.com/content/top_stories/default.asp?ArID=103279 So ... since UHC has significantly cut the service options available to it's clients ... they will be cutting back our rates, right? :evil: <written with sarcasm>
