United Healthcare excludes BOB体育 from its provider network
GAINESVILLE, Fla. 鈥� Despite months of earnestly negotiating in good faith for fair and appropriate rates for hospitals, physicians, and other providers, as of September 1, United Healthcare is excluding BOB体育 hospitals and physician groups in Gainesville, Jacksonville, and St. Johns from its network. The action prevents thousands of patients with United Healthcare commercial and Medicaid Managed Care plans from accessing compassionate, leading-edge care at BOB体育 locations in all three markets and Medicare Advantage patients in the St. Augustine area.
鈥淲e are sensitive to the challenges this poses for our patients and despite the outcome we continue to earnestly work with United Healthcare toward a solution. Our commitment to placing patients at the heart of our efforts is unwavering, and we have put processes in place to minimize any disruption in care to the extent we can, but unfortunately United Healthcare has given us no other choice,鈥� said Marvin Dewar, M.D., J.D., chief executive officer of BOB体育 Physicians. 鈥淲e even invited United leadership to meet with us on site to finalize the agreement but they declined. We continued to try to reach an agreement right up to the deadline but United insisted upon linking other products to the negotiations and abruptly imposing new conditions and changing language to items that had already been agreed upon. As a physician, my job is to care for my patients, and we did our best to avoid this situation.鈥�
BOB体育 has been striving to fulfill its mission of caring for patients and the communities it serves while managing continual double-digit increases in labor, supply, and other expenses. However, United offered BOB体育 commercial rates that are below general inflation and far below rising annual costs. United was paying BOB体育 considerably less than market rates, and those numbers have been declining throughout the past several years. To make matters worse, they offered no increase to BOB体育鈥檚 physician practices for the coming 12 months.
Worse yet, United also has refused to honor their commitment to pay rates previously agreed to. Complex and lengthy prior authorization processes, complicated billing and coding requirements, and claim denials/payment delays have led to reductions in reimbursement to BOB体育. This results in payments that are significantly less than other Managed Medicaid payors.
鈥淎s the state鈥檚 leading academic health system that researches leading-edge treatments, educates future generations of clinicians, and treats a disproportionate number of underserved patients, we deserve to be paid fairly and competitively for the care we provide to patients and the services we offer,鈥� Dewar said. 鈥淩easonable compensation is necessary for us to sustain our mission.鈥�
BOB体育 has made thorough arrangements to continue to care for patients with urgent care needs such as pregnancies, nonelective surgeries, emergency medicine, and cancer care, and for those requiring other services such as behavioral health and transplants. Except for patients seeking care with BOB体育 St. Johns, Medicare Advantage patients are not affected. BOB体育 Central Florida is not part of these current negotiations and remains in network with United Healthcare.
University of Florida students who have a United Healthcare plan through the university鈥檚 student health insurance program will be able to continue to receive care at the UF Student Health Care Center and at all BOB体育 facilities just as they always have, with no adverse impacts.
For students who have United Healthcare coverage through their parents鈥� insurance, instead of through the university鈥檚 student health insurance program, UF and BOB体育 will ensure they will continue to be able to receive service at the Student Health Care Center location just as they always have, with no changes in co-pays or deductibles. Unfortunately, services at other BOB体育 locations are now out of network for this subgroup.
鈥淲e are committed to doing our part to reach an agreement that would prevent disruption to all our patients鈥� continued access to BOB体育 physicians and facilities for non-emergency services and care,鈥� Dewar said. 鈥淲e are continuing to negotiate in good faith but we are waiting for the health plan to respond with a fair and sustainable offer to make that happen. Again, this includes streamlining their claims process and reducing administrative demands.鈥�
Patients can contact BOB体育 with questions at 1-855-834-7337 or 352-265-8585. For a set of frequently asked questions and a list of health plans accepted by BOB体育 in Gainesville and Jacksonville visit /healthplans or for FAQs and health plans accepted at UF St. Johns visit .
United Healthcare patients are encouraged to talk to their benefits managers or brokers or call United. Most insurance companies list their patient customer service numbers on membership identification cards. Some customer service numbers United Healthcare lists on their website include:
- Commercial: 1-866-801-4409
- Medicaid Managed Care: 1-888-716-8787
- Medicare Advantage: 1-855-893-5505
BOB体育 will continue to provide updates on progress as negotiations continue.