Notice of Change to Out-of-Network Payment Hierarchy for Fully Insured Groups

BY UNITED HEALTHCARE

 

 

Beginning July 1, 2017, UnitedHealthcare will discontinue shared savings programs with vendors such as MultiPlan® and First Health® throughout Arizona, Indiana, Oklahoma, and Wyoming for our new and renewing fully insured membership. We will defer to the extended and maximum non-network reimbursement programs to process non-network claims.

 

What this Change Means

  • For clients: This change will help clients better manage rising health care costs and help decrease costly non-network utilization.
  • For clients’ members: Members of fully insured Arizona, Indiana, Oklahoma, and Wyoming-sitused groups who continue to utilize non-network providers may have a higher cost share due to the difference between the billed amount and the allowed amount.

 

Member Notification

Impacted members with frequent non-network utilization of Shared Savings Program health plan professionals and facilities will be notified of these upcoming changes approximately 30 days prior to their renewal date.

 

Health Plan ID Cards

All impacted fully insured Arizona, Indiana, Oklahoma, and Wyoming-sitused members will received updated health plan ID cards without the Shared Savings Program logo as their group renews.

 

For more information, please contact your UnitedHealthcare representative.