United Healthcare Exits In-Network for Samaritan Patients
TL/DR –
Samaritan Health Services has terminated its contract with United Healthcare insurance, which may affect around 18,000 patients, most of whom are in the mid-Willamette Valley. Starting from January 9, 2024, Samaritan Health Services hospitals will be considered out of network under United Healthcare plans, and from November 1, 2024, Samaritan physicians and provider services will also be out of network. The reason for the termination is cited as United Healthcare’s processing of requests and claims, which Samaritan found made it difficult to provide timely access and appropriate care to patients.
Samaritan Health Services Ends Contract with United Healthcare, Affecting about 18,000 Patients
Samaritan Health Services recently announced the termination of its contract with United Healthcare, a move anticipated to impact nearly 18,000 patients, predominantly in the mid-Willamette Valley region. The news came as a surprise to many reliable United Healthcare insurance users.
From January 9, 2024, Samaritan Health Services hospitals will start to consider United Healthcare insurance as out-of-network, which extends to physician and provider services from November 1, 2024. Switching insurance plans once more will be a challenging task for many individuals.
About 18,000 individuals, as per United Healthcare’s data, are expected to be influenced by this change. Samaritan Health Services, with hospitals in Corvallis, Albany, Lebanon, Newport, and Lincoln City, caters to 290,000 residents in Linn, Benton, Lincoln, and parts of Polk and Marion counties.
It remains unclear why the contract was ended. However, according to Samaritan, United Healthcare’s handling of requests and claims made it hard for them to provide timely access and appropriate care to patients. The Samaritan Health Services President and CEO, Doug Boysen, stated that the processing of requests and claims made United Healthcare a difficult insurance company to work with.
Challenges have also been faced in discharging United Healthcare-insured patients to skilled nursing facilities. These issues have been ongoing but intensified in the past two years. Patients who decide to stay with United Healthcare will be required to pay out-of-network charges, excluding emergency care.
Insurance broker and Albany Mayor, Alex Johnson II, reported an upsurge in calls from worried individuals seeking information about their insurance coverage. Clients’ main concerns revolve around loss of coverage, retention of their doctors, and cost impacts. Some are worried about how and if their planned surgeries or appointments will be covered.
Patients can find out more about the other insurance plans Samaritan contracts with by visiting samhealth.org/insuranceBilling. Residents can look forward to receiving further updates during the insurance open enrollment period for 2024.
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