UnitedHealth puts Envision's ED billing policies in its crosshairs: 5 things to know

UnitedHealthcare, the health insurance arm of UnitedHealth Group, created a website targeting Envision Healthcare's emergency department billing policies amid an ongoing payment dispute.

Here are five things to know.

1. The website, which focuses on why UnitedHealthcare is renegotiating a contract with Envision, asks members, "Shocked by your ER bill? Learn why the cost of ER services are skyrocketing and what we're doing to protect you." The site then links to a fact sheet on Evision's out-of-network rates.

2. On the fact sheet, UnitedHealthcare states Envision is the "largest ER physician staffing firm in the country and its outrageous billing practices are increasing costs for hospitals and consumers."

3. Among the statistics UnitedHealthcare lists on its fact sheet, it argues Envision charges 975 percent of Medicare for its ER physicians. "Hospitals are working hard to lower costs and create a better patient experience, but outsourced ER companies are setting their efforts backward," UnitedHealthcare writes. 

4. The website is the latest in an ongoing feud between the payer and provider. On March 14, Bloomberg reported UnitedHealth tossed its attempt to acquire Envision's ambulatory services unit, according to sources familiar with the matter. The news came as Envision sued UnitedHealth for allegedly lowering contracted payments to Envision physicians and not allowing new Envision medical practices to join its network.

5. In a statement to Becker's Hospital Review, Envision said: "As stated in our complaint against UnitedHealthcare, UnitedHealthcare is in breach of contract by failing to recognize Envision medical providers, unfairly adjusting rates it pays Envision and refusing to comply with the contract's process for handling disputes. This is the next step after multiple attempts to resolve the situation. We are asking the courts to hold United accountable for its contractual agreements and obligations.

"Envision believes that UnitedHealthcare is choosing to place dedicated physicians and patients in the middle of a contractual dispute to further its competitive business strategies."

More articles on payer issues:
South Carolina health system hits contract snare with Cigna
Cigna CEO: Express Scripts deal about 'capabilities, reach, quality, affordability'
Medicare to cover genomic testing for advanced cancer patients

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Articles We Think You'll Like