UnitedHealthcare in Contract Network Negotiations with TeamHealth

NRECA has been informed that TeamHealth, a national physician staffing company that delivers emergency medicine, anesthesiology, hospitalist (doctors who coordinate hospital care), ambulatory care and behavioral health care services, terminated the first of several network contracts with UnitedHealthcare (UHC) on October 15, 2019. Additional contract terminations could follow later in 2019 and 2020.

Cooperatives in areas affected by the October 15 termination have been contacted by email.
 
UHC and TeamHealth are in active contract negotiations. UHC’s goal is to protect patients from high costs for emergency services and other contracted care.

NRECA will continue to cover claims at the in-network benefit level for a period of time to minimize disruption.

As a reminder, under the NRECA Medical Plan, emergencies are paid at an in-network benefit level using the following criteria:

• Out-of-network emergency room doctors are paid at in-network pricing levels when the facility is in-network.
• Out-of-network facilities are paid at the in-network benefit level when the diagnosis qualifies as an actual emergency. This also applies to any surgery performed at that time.
• Radiologists, anesthesiologists, pathologists and labs are always paid at the in-network level when services are rendered at an outpatient or inpatient facility. This benefit applies regardless of the hospital’s or physician’s participating status.    

NRECA will continue to monitor the situation and will keep affected co-ops apprised of the status of negotiations as additional information becomes available.

If you have any questions, contact your field representative. You also can contact the Member Contact Center at 866.673.2299 or contactcenter@nreca.coop.