Ask why UHC is the only insurance company not contracted with the hospital’s anesthesia professionals and why UHC may be increasing your financial obligation. Bring our sample letter (below) to your HR department.
This will allow USAP to appeal your claim and request fair payment from UHC. You should not be held responsible for higher out-of-pocket costs
Contact the member phone number on your health plan ID card and request for your claim to be treated as in-network. Request an updated Explanation of Benefits (EOB) that confirms you are treated as in-network. The EOB will show any costs for which you are responsible as if the services were from an in-network provider.
For the past 17 years, USAP and its predecessors have been in-network with UnitedHealthcare. Despite a strong desire on our part to remain in-network, United effectively forced us out of network by attempting to unilaterally reduce our recently-negotiated fees by a significant and unacceptable amount. As of September 1, 2019, USAP is no longer in-network with UnitedHealthcare in Washington. We are currently participating as an in-network provider with all other major insurance plans in Washington. USAP remains committed to engaging with UnitedHealthcare in hopes of going back in network at reasonable rates consistent with our prior agreement.
We are communicating with UnitedHealthcare to reach agreement on reasonable rates consistent with our prior agreement. We will pursue all possible actions to ensure that UHC honors its commitments to our clinicians and their patients.
When your USAP claim is treated as "out-of-network," it potentially increases your out-of-pocket costs. Your care with USAP did not end when you left the hospital. USAP wants to work with you to appeal your claim and reduce your cost as much as possible. One of the ways you can help with that is to complete and return a "UnitedHealthcare Appointment of Representative" form. This will allow USAP to appeal your claim and request fair payment from UnitedHealthcare. You should not be held responsible for higher out-of-pocket costs. You can contact The USAP Patient Advocacy Team at (833) 479-0697 to obtain a copy of this form and discuss additional ways we can help you.
It’s important to know that only USAP physicians, CRNAs, and staff will be considered out-of-network. The facilities, your surgeon, and other physicians involved in providing your care will not be affected by our status with UnitedHealthcare. As always, please contact all other providers and facilities involved in your care to determine if they are in-network.
However, because UnitedHealthcare has excluded us from their network, your cost of care may be higher, depending on how UnitedHealthcare processes your claim. For example, your coinsurance may be higher, and they may apply your payments to an out-of-network deductible instead of in-network, therefore making the cost of your other care higher. We also want to help and have programs in place that may reduce your balance.
We understand this can be challenging, and we encourage you to reach out to your insurer to ask that your claim to be treated as though we are in network. It’s fair to count on your health plan to include quality providers.
Free copies of the USAP Financial Assistance Policy and Financial Assistance Application are available online at usap.com/patient-advocacy. Free copies can also be requested by mail at 3705 Medical Parkway, Suite 570, Austin, TX 78705. The USAP Patient Advocacy Team is available to answer questions and assist with the application process at 833-479-0697.
Absolutely. We remain committed to continuing to provide the highest quality care for all patients, including UnitedHealthcare patients.
A few things:
Complete and return the "UnitedHealthcare Appointment of Representative" form. This will allow USAP to appeal your claim and request fair payment from UnitedHealthcare.
Contact your employer or plan sponsor regarding the handling of this claim. Make it clear that you want your anesthesia provider to be in your network. It's fair to count on your health plan to include quality providers. Please contact our toll-free patient advocacy line at (833) 479-0697 to request a copy of a letter that you can mail or email to your employer.
Call UnitedHealthcare. Contact the member phone number on your health plan ID card and ask for your claim for anesthesia services to be treated as in network. Request an updated Explanation of Benefits (EOB) to reflect this change.
If you have any questions, please contact the patient advocacy team at PatientAdvocacy@usap.com or by phone at (833) 479-0697.
Confidential USAP-United Healthcare contract data
USAP Survey Vitals, 2019