UnitedHealthcare, Erlanger upbeat on solving contract disputes - Independent Insurance Consultants | Medicare and Life Insurance | Independent Insurance Consultants | Medicare and Life Insurance

UnitedHealthcare, Erlanger upbeat on solving contract disputes

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UnitedHealthcare and Erlanger Health System may be showing signs of holiday cheer. The icy standoff between the insurer and the hospital may be thawing.

After a months-long standoff and a week of negotiations, the insurer and the hospital struck an upbeat tone about their likelihood of reaching an agreement on both their TennCare insurance contract, which was terminated in October, and their commercial contract, which was set to expire at the end of this month.

“We continue to make progress on a renewed contract with Erlanger and are optimistic we will be able to continue their participation in our network,” United spokesman Daryl Richard said.

Erlanger vice president of payer relations Steve Johnson struck a similar note. “We’ve had productive discussions and we’re optimistic that we’ll be able to reach an agreement,” he said.

The words are a stark change in tone for both parties. Erlanger has repeatedly said that United offered “unreasonably” low rates, and that the insurer has a history of payment problems. United, meanwhile, has said the hospital walked away from fair offers.

The stalemate has caused turmoil for families on Tenn-Care, and for employers unsure about whether their employees would have access to the area’s largest hospital after the first of the year.

The tidings of a potential reunion are welcome to people like Soddy-Daisy resident Amy Skiles, 37, who launched a social media campaign decrying the fact that she and her two children have not been able to get much-needed care.

Skiles and her children, ages 10 and 11, are on Tenn-Care’s UnitedHealthcare plan. The mother has back problems, one of her children has epilepsy and another needs foot surgery. But none can be treated by their doctors or by the region’s only children’s hospital, T.C. Thompson Children’s Hospital at Erlanger, because the hospital is no longer in United’s TennCare network.

“No one should have to worry about their children’s access to health care like this,” Skiles said. She has posted complaint after complaint to the insurer’s Facebook page.

Dr. Pete Kelley, a pediatric surgeon with University Surgical Associates, said doctors in his practice have had to refer patients to hospitals in Nashville and Knoxville for treatments they should have been able to get at Erlanger.

But he said he understands Erlanger’s position. University Surgical has been embroiled in its own tense negotiations with United after deciding to terminate all contracts with the insurer this fall.

“I would like to be able to see any patient, I would like for them to be able to go to any hospital. But I know Erlanger has to look out for its financial viability,” Kelley said. “I would hope they could come to terms about United, but I understand if they can’t. We still have our own issues with them.”

While Skiles said she is encouraged by the possibility of a breakthrough, she is going to continue fighting for access to the hospital until her family and other families see it restored.

“Until this is rectified, I will continue to make our voices heard,” Skiles said.

Contact staff writer Kate Harrison Belz at kbelz@timesfreepress.com or 423-757-6673.

Erlanger Hopsital

 

 

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