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In one week, many residents may be left without affordable access to one of the area’s largest health systems.
According to Northeast Georgia Health System, as of Aug. 22 its services will be considered out of network with UnitedHealthcare unless negotiations for a new contract come to fruition.
“This means many families across Northeast Georgia will have limited access to our facilities and our physician group and may be required to leave the area for the services they now receive close to home unless they want to pay higher out-of-pocket costs imposed by United,” said Melissa Tymchuk, a spokeswoman for the health system, in a press release.
The current contract is set to expire on Aug. 21 and if a new agreement is not reached by then, the system and its physician group, Northeast Georgia Physicians Group, will be out of network as of Aug. 22.
“UnitedHealthcare has been conducting frequent negotiations with Northeast Georgia Health System,” said Tracey Lempner, spokeswoman for United, in an email. “We believe that we have put together a contract that is fair and offers our members access to quality, affordable care.
“We are hopeful that we will reach a new agreement with Northeast Georgia Health System and continue to negotiate the final details of a new contract.”
Tymchuk confirmed the two organizations are meeting again this morning.
“We are hopeful every day that we’ll come away with a completed contract,” she said. “But we’re hoping (today) they can get together and come to some resolution on some of these pieces.”
According to a press release issued by the health system, negotiations began this January. It was hoped the talks would wrap up by June 20.
But, Tymchuk said, sometimes these contract negotiations go right up to the deadline.
“It has happened before,” she said. “We did go late into the process with Cigna last year. It certainly doesn’t happen with every contract, thank goodness, but it can happen from time to time where you just can’t come to an agreement until right before the deadline. It’s certainly not how we want it to play out.”
Tymchuk said some language in the new contract is what is holding up the process — not reimbursement rates that can sometimes bog down talks.
“We pressed forward, and in fact, most contract terms about reimbursement rates have been settled for some time. However, we are not willing to compromise on contract language that threatens our financial stability, limits our ability to improve coordination of care in the future or puts quality of care at risk. We can’t accept an agreement that harms our patients’ future local access to in-network care or relationships with their valued health care providers.”
But some United insurance holders said the uncertainty is worrisome.
“I can’t make my son’s yearly appointment because I don’t know where I’m going to make the appointment,” said Tonya Weckler, a United policyholder. “I would imagine that there are a lot of people in Gainesville that have UnitedHealthcare.”
Tymchuk said certain patients may be able to still receive care after Aug. 21 if negotiations do not prove successful. Patients who are hospitalized, pregnant or currently undergoing active treatment for acute or chronic conditions could be covered under continuity of care conditions.
Patients would have to confirm that with United.
“It does put patients, employees and employers in a bad position where they’re not sure what’s going to happen with their insurance,” said Tymchuk. “It can cause uncertainty and it’s not something we want happening for our patients.”













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