Mississippi health system blames Humana split on improper denials

Tupelo-based North Mississippi Health Services notified patients it is ending a provider network agreement with Humana's Medicare Advantage plans due to frequent denials, according to the Daily Journal.

The agreement will end Jan. 1, 2019, unless the issue is resolved. North Mississippi Health Services, the parent company of various North Mississippi Medical Center hospitals, said it was allocating too many resources to appealing denials associated with Humana's Medicare Advantage plans.

"Only 4 percent of our patient base uses Humana Medicare Advantage, but Humana Medicare Advantage accounted for 85 percent of all denials by all payers," Shane Spees, CEO of North Mississippi Health Services, told the Daily Journal.

The health system and Humana have been negotiating the issue since June.

"For several months this year, Humana has engaged in good-faith negotiations with NMHS on a new contract," the health insurer told the publication in a written statement. "But, to date, North Mississippi has not agreed to terms that are reasonable for our health plan members and customers."

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