Channel Sponsor - Coding/Billing/Collections

Sponsored by National Medical Billing Services | | (636) 273-6711

Optum to re-direct patients amid UnitedHealthcare-Houston Methodist dispute


UnitedHealthcare plans to drop Houston Methodist hospital system from its in-network providers at the end of the year, and Optum will be directing patients away from the system's eight hospitals as a result, reported the Houston Chronical


The insurer and health system have been unable to negotiate a new contract, and UnitedHealthcare announced it plans to drop Houston Methodist from its network so all of the system's hospitals and facilities will be out-of-network on Jan. 1, 2020. Employed physicians will be out-of-network effective April 1, 2020.

However, Optum, which is a part of UnitedHealthcare, plans to begin sending new transplant patients away from Houston Methodist beginning Oct. 14. According to the Houston Methodist website, UnitedHealthcare directed Optum to send members elsewhere for care. Existing transplant patients would still be covered at Houston Methodist, according to the Chronical.

UnitedHealthcare maintains that Houston Methodist overcharges patients and the Chronical reported CEO of UnitedHealthcare commercial plans for Texas Dave Milich said: "Their costs are not in line with similar institutions. If you're going to hold yourself up as one of the top hospitals, then we're going to compare you to them as far as relevant cost."

© Copyright ASC COMMUNICATIONS 2021. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.


Featured Webinars

Featured Whitepapers