Local News

Deadline Passes Without New Deal Between United Healthcare, WakeMed

Posted February 28, 2007
Updated March 1, 2007

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— A deadline passed Wednesday evening for WakeMed and the insurer UnitedHealthcare, which ends their relationship after a dispute over how much the carrier pays the hospital for services its members receive.

UnitedHealthcare is one of the Triangle's largest health-insurance companies, and it would like to pay prices more like the lower ones Blue Cross Blue Shield of North Carolina pays. WakeMed says prices are based on how much business an insurer brings into the hospital and that it cannot afford to give UnitedHealthcare a better deal.

Without a contract, UnitedHealthcare patients who use WakeMed will be going out of their approved network for services and insurance will cover less of the expenses.

Officials at WakeMed said they do have a remedy for those who still want to go to WakeMed. The hospital has printed up pamphlets explaining how UnitedHealthcare members may be able to get treatment without paying any more than they would have.

The hospital has a plan to cover out-of-pocket costs on a case-by-case basis for those who choose to go out of network.

About 200,000 card-holders in the Triangle will lose coverage at WakeMed.

"We will make up the difference financially for that individual patient," Deborah G. Friberg, WakeMed's executive vice president and chief operating officer, said.

WakeMed has set up a hotline for United Healthcare members: 919-350-CARE (2273).

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  • jeneric43 Mar 1, 2007

    Blessed, where are you facts to back up that healthcare providers are getting paid more each year, day, etc for the same procedure? False. If new and more costly technology is used, then yes, the cost would increase. Otherwise, no, that is price gouging and is illegal.

  • purplepat777 Mar 1, 2007

    Don't be too easily fooled into thinking your emergency visit will be covered by UHC if you go to WakeMed. UHC will not cover your visit unless it is a "true emergency". So, if you go to WakeMed's ER, you better hope they admit you and perform a procedure of some kind or you'll have a battle on your hands getting UHC to cover the expenses. I speak from experience.

  • Blessed Mar 1, 2007

    Trooper, I agree. It is actually time that insurance is provided in a way that is non-profit and national coverage may be the only way that can happen. The problem is, if you go to national coverage, then your doctor will be paid even less for his services than he is paid now (which believe me, ain't much). Everyone talks about rising healthcare cost, but the only cost that is rising is what we the insured are having to pay the insurance companies, the amounts they pay to the medical providers (doctors, hospitals, etc) have steadly gone down each year. So if the insurance company is paying out less and we are paying in more, then where is the rest of our money going? The deep pockets of the senior management of the insurance companies.

  • Trooper Mar 1, 2007

    sounds to me like we need to go to nationalized health care, that way we could put the insurance companys out of business and everyone would get the same health coverage and perscriptions. the United States is supporting at least half the world, I think its time to provide healthcare for our own people.

  • wakeresident Mar 1, 2007

    I meant 6 ultrasounds... not 60! Sorry.

  • wakeresident Mar 1, 2007

    Wake1, you are absolutely right. For emergency treatment, all insurance carriers are required to provide care at the closest hospital. So, if you're going from Apex, WakeMed Cary is closer, and therefore, UHC would have to pay. It's different for nonemergency stuff. I recently had emergency surgery in Wake Forest, and even if that hospital wasn't "covered" my surgery would have been. Crystal, BCBS may charge a lot, but you get a lot. My prenatal care has been free. Every single bit of it, every doctor's visit, every ultrasound (and I've had about 60, every blood test, even those to test for abnormalities (i.e. not simply routine). They've sent me books on pregnancy and childcare. I even have access to a free nutritionist. If you want just the basics, you should go with someone else. I'm not being rude, just stating a fact. You can get a lower rate with another company, if you don't want the above and beyond.

  • Wake1 Mar 1, 2007

    And if I'm not mistaken, your care will still be covered at WakeMed for emergencies. As the only Level 1 trauma center in Wake County, if it's necessary that you need Wake, UHC will have to pay for it. WakeMed is also going to work with patients to help ease their out of pocket burden if they still continue to use WakeMed services.

  • emtbuff Mar 1, 2007

    As a UHC subscriber myself I can certainly sympathize with other's concerns, but please folks, let's remember nobody is telling you that you CAN'T use WakeMed- you have the choice, and in an emergency it's where I'm going as it's my closest hospital. I really don't care the extra cost. You still have the freedom to decide on your own about where you go for services so please stop saying you CAN'T use WakeMed. JMHO.

  • mom2threecld Mar 1, 2007

    thank you blisstate, also how many patients do we getfor extended visits that are listed as self pay that are never able to pay? wake med eats the costs of millions of dollars in health care each year,unlike rex. if you don't have insurance, rex won't even blink at you. wake med serves regardless of ability to pay

  • spiritwarriorwoman Mar 1, 2007

    112006 - YOU ARE WRONG! WakeMed and UHC are only in the THIRD year of a FIVE year contract, and now UHC realizes they made a bad agreement in the first place and terminates the contract midstream. I have been so well cared for at WakeMed and pray that my employer dumps UHC in favor of another company in the future. God bless. Rev. RB