Amid worries regarding Norman Regional Hospital System’s continued network arrangement with UnitedHealthcare, the two reached an agreement ensuring the hospital system will remain in-network for one year, according to a statement released by Norman Regional Tuesday.
The agreement came after concern that UnitedHealthcare would be out of network Thursday if an agreement was not made.
UnitedHealthcare is one of the largest health insurance providers in the United States and supplies health coverage and benefits programs to more than 49 million consumers across the nation, according to a research report.
According to Norman Regional Hospital System President and CEO Aaron Boyd, the agreement resulted in a 1% increase in Norman Regional’s payment rate, with plans to further negotiate in the future. For Norman Regional Hospital System, the payment rate affects how much it is reimbursed by insurance companies for services provided and how much patients will have to pay as a result.
“Again, not all we wanted, but something, and mainly now we have a year for them to be prepared and for us to be prepared as we negotiate even better,” Boyd said.
The agreement will ensure undisrupted coverage for UnitedHealthcare policyholders, and will extend to all UnitedHealthcare policies — including commercial and Medicare Advantage plans — which will maintain all emergency, inpatient and outpatient services.
“Healthcare is very personal and we thank our patients for understanding as we navigated the
contract process,” Boyd said in the statement. “We understand that a patient’s relationship with their doctor is extremely important, as well as having expert care close to home. We’re able to continue providing that compassionate care to UHC patients.”
Along with the updated payment rate, the agreement will mean an increase in claim and denial interactions with UnitedHealthcare.
“We’ve got to get aggressive and think with them about those and understand why they’re getting denied,” Boyd said. “So, there's more than just the dollars we’re paid. It’s about working with them going forward to just get a better product for our patients.”
In order to reach a more beneficial agreement in the future, Boyd said he thinks Norman Regional Healthcare System and UnitedHealthcare will need to find mutual understandings. This will include UnitedHealthcare measuring Norman Regional with hospitals of similar scale when UnitedHealthcare considers payment rates in relation to other hospitals in the area.
“If we’ve got all our data correct and we’re in the right group of hospitals, when they look at us, they can see that we’re behind, but we have to do that work and make sure everybody’s on the same page,” Boyd said.
Though it was not what Norman Regional wanted, Boyd believes the agreement is a first step toward getting a budget to help the hospital and its patients.
“We’ve got to take care of the patient, and that’s really where it starts,” Boyd said.
This story was edited by Spencer Windholz and Audrey McClour. Tori Pham and Larkin Bock copy edited this story.
