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Here’s hospital’s update on UnitedHealthcare contract expiration

If you call Boca Raton Regional Hospital, you can opt to hear a recording on the UnitedHealthcare situation. The contract with the hospital ended July 1.

Below are Frequently Asked Questions the hospital issued as of July 18.

Q: Is Boca Raton Regional Hospital still accepting UnitedHealthcare as a supplemental insurance to regular Medicare?

A: Boca Raton Regional Hospital still accepts UnitedHealthcare Medicare supplements to traditional Medicare policies.

Q: If a patient sees a doctor who is affiliated with the hospital, are the doctors still taking UnitedHealthcare? Are the tests or procedures in the hospital affected? Are there certain UnitedHealthcare policies that the hospital still takes?

A: BocaCare doctors and Boca Raton Regional Hospital Urgent Care Centers remain in-network with UnitedHealthcare at this time. However, Boca Raton Regional Hospital and Boca Raton Regional Hospital Outpatient Diagnostic Imaging Centers are out of network with UnitedHealthcare as of July 1, 2019. After July 1, 2019, UnitedHealthcare will likely not authorize new elective services at Boca Raton Regional Hospital that are not part of an ongoing continuation of care episode. We are working with our doctors and patients to accommodate new elective UnitedHealthcare cases at one of our… in-network Baptist Health South Florida facilities in the UnitedHealthcare network.

We encourage UnitedHealthcare patients to stay in touch with their doctors to ensure their care needs are followed. As of July 1, 2019, all UnitedHealthcare plans (except United’s Medicare Supplemental plans) are out of network with Boca Raton Regional Hospital and Boca Raton Hospital Outpatient Diagnostic Imaging Centers.

The plans that are out of network with Boca Raton Regional Hospital and Boca Raton Hospital Outpatient Diagnostic Imaging Centers as of July 1, 2019 include all commercial, Medicare (except supplemental plans), Medicaid, out-of-state, Neighborhood Health and Oxford plans.

Q: For patients in the hospital with UnitedHealthcare prior to June 30, who are in Rehabilitation or mid-stay, how will this be handled?

A: Patients who have already started to receive care at Boca Raton Regional Hospital may be allowed to complete their scheduled care under their in-network UnitedHealthcare benefits within the following guidelines:

·    Prenatal care during any trimester

·    Currently receiving a course of radiation or chemotherapy for cancer

·    Currently undergoing a staged surgery (e.g. breast reconstruction)

·    Admitted under in-network benefits for medically necessary services before July 1, 2019, and who will not be discharged until after that date

In all cases, you should contact UnitedHealthcare before treatment to make sure services are covered by calling the telephone number on the back of your UnitedHealthcare member ID card.

You may also need to contact UnitedHealthcare’s Medical Management Department with questions about your Continuity of Care benefit coverage.

Q: Which UnitedHealthcare plans are affected?

A: As of July 1, 2019, all UnitedHealthcare plans (except UnitedHealthcare’s Medicare Supplemental plans) are out of network with Boca Raton Regional Hospital and Boca Raton Hospital Outpatient Diagnostic Imaging Centers. The plans that are out of network with Boca Raton Regional Hospital and Boca Raton Hospital Outpatient Diagnostic Imaging Centers as of July 1, 2019, include all commercial, Medicare (except supplemental plans), Medicaid, out-of-state, Neighborhood Health and Oxford plans.

Q: Will my physician’s participation status with UnitedHealthcare be affected?

A: At this time, BocaCare doctors remain in network with UnitedHealthcare plans, however, Boca Raton Regional Hospital and Boca Raton Regional Hospital Outpatient Diagnostic Imaging Centers are out of network with UnitedHealthcare as of July 1, 2019. We have not been informed of any changes to UnitedHealthcare’s physician network at this time. However, should you have any questions about your doctor’s participation with UnitedHealthcare, you should contact your doctor or UnitedHealthcare directly for more information.

Q: What is the probability that both parties will reach a new agreement?

A: Boca Raton Regional Hospital has a longstanding relationship with UnitedHealthcare and is committed to working collaboratively to reach a new agreement, however, the timing of the resolution is unknown at this time.

Boca Raton Regional Hospital…participates with a broad range of insurance plans. If Boca Raton Regional Hospital is important to you and your healthcare needs, we encourage you to consider choosing a plan that includes Boca Raton Regional Hospital as an in-network provider at your next open enrollment.

A list of Boca Raton Regional Hospital’s accepted insurance plans can be located online.

Q: Can patients receive care at Boca Raton Regional Hospital after the July 1, 2019 termination date?

A: Emergency services should be covered by the patient’s insurance plan regardless of whether the plan is in-network or out-of-network with the provider. In addition, patients who have out-of-network benefit coverage can elect to receive elective services at Boca Raton Regional Hospital, although they may experience higher cost-sharing for out-of-network providers.

Q: What about patients who already started treatment at Boca Raton Regional Hospital prior to July 1, 2019?

A. Patients who have already started to receive care at Boca Raton Regional Hospital may be allowed to complete their scheduled care within the following guidelines:

• Prenatal care during any trimester

• Currently receiving a course of radiation or chemotherapy for cancer

• Currently undergoing a staged surgery (e.g. breast reconstruction)

• Admitted under in-network benefits for medically necessary services before July 1, 2019, and who will not be discharged until after that date.

In all cases, you should contact UnitedHealthcare before treatment to make sure services are covered by calling the telephone number on the back of your UnitedHealthcare member ID card.

You may also need to contact UnitedHealthcare’s Medical Management Department with questions about your Continuity of Care benefit coverage.

Q: If I seek services at another hospital, will I be able to have my existing physician treat me there?

A: You should check with your physician.

Q: What can I do to communicate my concerns to UnitedHealthcare?

A: If you wish to contact UnitedHealthcare, you can do so by calling the member services phone number on the back of your member ID card.

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